Bone Tumors

Question 1

Associated with dull pain that is worse at night and is relieved with salycilates.

Answer 1

Osteoid Osteoma

• 50% in tibia/fibula
• 2nd-3rd decades

Question 2

Sometimes called a giant osteoid osteoma.

Answer 2

Osteoblastoma

• 2nd-3rd decades
• Less reactive sclerosis than OO
• Less symptoms than OO

Question 3

What bone tumors are more common in females?

Answer 3

1. Parosteal Osteosarcoma
2. Giant Cell Tumor
3. Aneurysmal Bone Cyst

Question 4

Called the “ugly” type of osteosarcoma.

Answer 4

Telangiectatic Osteosarcoma

• Prognosis same as medullary
• See fluid-fluid levels

Question 5

Multiple enchondromatosis and usually presents as a growth disturbance in childhood.

Answer 5

Ollier’s Disease

Question 6

Multiple enchondromas with soft tissue hemangiomas.

Answer 6

Maffucci’s Disease

Question 7

Cloud-like or amorphous describe what type of tumor matrix?

Answer 7

Osseous

Question 8

Punctate or c-shaped describe what type of tumor matrix?

Answer 8

Cartilage

Question 9

Ground-glass describes what type of tumor matrix?

Answer 9

Fibroosseous

Question 10

A “kid with a painful lesion in the epiphysis” usually indicates what?

Answer 10

Chondroblastoma

• Usually knee, hip, or foot
• 2nd-3rd decades

Question 11

A cartilage capped bony excrescence in the metaphysis that points away from the joint indicates what?

Answer 11

Osteochondroma

-Usually discovered in adolescence

Question 12

Multiple exostosis of osteochondromas indicates what?

Answer 12

Multiple Hereditary Osteochondromatosis

• AD
• incomplete penetrance

Question 13

Also known as Nora’s Lesion.

Answer 13

Bizarre Parosteal Osteochondromatous Proliferation (BPOP)

• high local recurrence
• 3rd-4th decade

Question 14

Which tumors are found in the epiphysis?

Answer 14

1. Chondroblastoma
2. Clear Cell Chondrosarcoma
3. Intraosseous Ganglion

Question 15

Which tumors arise at growth plates and migrate into the diaphysis?

Answer 15

1. Nonossifying Fibroma (NOF)

2. Unicameral Bone Cyst (UBC)

Question 16

Multiple NOFs with cafe au lait spots indicates what?

Answer 16

Jaffe-Campanacci Syndrome

-DO NOT biopsy

Question 17

This tumor has geographic borders and a ground glass appearing matrix. It’s hypointense of T1 but hyperintense on T2 (frequently heterogenous).

Answer 17

Fibrous Dysplasia

Question 18

Jagged edged cafe au lait spots, polyostotic FD, and endocrine abnormalities indicates what?

Answer 18

Albrights Syndrome

Question 19

Polyostotic FD with intramuscular myxomas indicates what?

Answer 19

Mazabrauds Syndrome

Question 20

Intracortical FD that occurs in early childhood and then becomes stable.

Answer 20

Osteofibrous Dysplasia (Ossifying Fibroma)

• Almost always in tibia
• May be related to adamantinoma

Question 21

Tumor of the metaphysis that extends into the epiphysis.

Answer 21

Giant Cell Tumor (GCT)

• 2nd most common primary tumor of sacrum
• 25-40 y/o
• Presents with pain

Question 22

Sometimes referred to as a “solid ABC.”

Answer 22

Giant Cell Reparative Granuloma

-Usually < 20 y/o in hands and feet

Question 23

Associated with “fallen fragment” sign.

Answer 23

Unicameral Bone Cyst (UBC)

• fallen fragment: bone fragment in dependent portion of cystic bone lesion
• 90% in humerus or femur

Question 24

More common in females and associated with fluid-fluid levels.

Answer 24

Aneurysmal Bone Cyst (ABC)

-10-20 y/o

Question 25

Most commonly found in the medial malleolus and resembles a subchondral cyst.

Answer 25

``` Intraosseous Ganglion (IOG) -40 y/o ```

Question 26

See onion skin periosteal reaction on radiograph and presents with pain, low-grade fever, weight loss, and elevated SED rate.

Answer 26

Ewings Sarcoma - Rare in blacks - Diaphyseal or metaphyseal - Usually < 20 y/o

Question 27

Has the same appearance as Ewings Sarcoma and presents with pain but usually has no systemic symptoms.

Answer 27

Primary Lymphoma of Bone | -30-40 y/o

Question 28

The most common primary malignancy of bone.

Answer 28

Multiple Myeloma - 45-80 y/o - Plasmacytoma: solitary lesion - Presents with pain, weakness, or neurological symptoms - POEMS Syndrome

Question 29

Noninfectious granuloma with proliferating histiocytes and eosinophils.

Answer 29

Eosinophilic Granuloma - Diaphysis - < 15 y/o

Question 30

Associated with triad of diabetes insipidus, exopthalamos, and bone lesions.

Answer 30

Hand-Schuller-Christian Disease - Multifocal eosinophilic granulomas, single organ system - 5-10 y/o

Question 31

Multifocal eosinophilic granulomas affecting multiple organs.

Answer 31

Letterer-Siwe Disease - Lethal in infancy - < 2 y/o