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Bone Tumors Flashcards

(61 cards)

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1
Q

Key radiologic features

A

Bones involved, location, lytic vs sclerotic, tumor margin/zone of transition, matrix formation, periosteal reaction, soft tissue involvement

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2
Q

Cartilage/chondroid producing tumors

A

Endochondroma, osteochondroma, chondrosarcoma, chondroblastoma, chondromyxoid fibroma

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3
Q

Bone producing tumors

A

Osteoid osteoma/osteoblastoma, osteosarcoma

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4
Q

No matrix/unknown cell type

A

Giant cell tumor of bone, non-ossifying fibroma, Ewing sarcoma, aneurysmal bone cyst, fibrous dysplasia

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5
Q

Enchondroma definition

A

Benign tumor of hyaline cartilage

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6
Q

Enchondroma age and sex

A

20-50 years old, males and females equally affected

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7
Q

Enchondroma common locations

A

Metaphysis of long bones, tubular bones of hands and feet

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8
Q

Enchondroma gross appearance

A

Lobules of cartilage in medullary cavity

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9
Q

Enchondroma histologic features

A

Circumscribed lobules of cartilage with low cellularity

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10
Q

Enchondroma syndromes

A

Ollier’s disease and Maffucci syndrome

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11
Q

Osteochondroma definition

A

Benign mixed tumor

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12
Q

Osteochondroma age and sex

A

10-30 years, males and females equally affected

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13
Q

Osteochondroma locations

A

Long bone metaphysis

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14
Q

Osteochondroma gross appearance

A

Mushroom shaped growth at metaphysis

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15
Q

Osteochondroma histologic features

A

Cartilage cap with underlying bone and marrow in stalk, cap points away from joint

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16
Q

Osteochondroma syndromes

A

Multiple hereditary exostosis (MHE)

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17
Q

Chondrosarcoma definition

A

Malignant sarcoma that forms cartilage

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18
Q

Chondrosarcoma age and sex

A

50-70 years, unless associated with syndrome, males and females equally affected

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19
Q

Chondrosarcoma locations

A

Axial skeleton more often than appendicular skeleton

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20
Q

Chondrosarcoma gross appearance

A

Can look like enchondroma but often shows destruction of cortex and soft tissue invasion

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21
Q

Chondrosarcoma histologic features

A

Lobules of more cellular cartilage that entrap host trabecular bone and destroy cortex

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22
Q

Chondrosarcoma syndromes

A

Ollier’s disease, Maffucci syndrome, multiple hereditary exostosis (MHE), the most common sarcoma in Paget’s disease

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23
Q

Osteoid osteoma/osteoblastoma definition

A

Circumscribed benign bone tumors

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24
Q

Osteoid osteoma/osteoblastoma age and sex

A

10-20 years, males more often affected than females

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25
Osteoid osteoma/osteoblastoma locations
Osteoid osteoma - metaphysis of long bone | Osteoblastoma - spine
26
Osteoid osteoma/osteoblastoma gross appearance
Central lucent area surrounded by abundant new bone
27
Osteoid osteoma/osteoblastoma histologic features
Central lytic bone forming area with reactive surrounding sclerosis
28
Osteoid osteoma/osteoblastoma syndromes
None
29
Osteosarcoma definition
Malignant bone forming sarcoma
30
Osteosarcoma age and sex
Bimodal age, but most are younger than 20 years old, males are affected more than females
31
Osteosarcoma locations
Metaphysis of long bones, especially of knee
32
Osteosarcoma gross appearance
Destructive tumor with bone with or without cartilaginous area
33
Osteosarcoma histologic features
Malignant osteoblasts form immature tumor bone
34
Osteosarcoma syndromes
Hereditary retinoblastoma, Li-Fraumeni, others
35
Giant cell tumor of bone definition
Benign in almost all cases but has aggressive local destructive growth, non-aggressive “metastases”
36
Giant cell tumor of bone age and sex
Adults, 20-40 years old (epiphysis closed), males and females equally affected
37
Giant cell tumor of bone locations
Epiphysis (can invade into metaphysis and diaphysis) of long bones, distal radius, pelvis
38
Giant cell tumor gross appearance
Large lesion located in the epiphysis of bone, sometimes surrounded by smaller, similar looking lesions
39
Giant cell tumor of bone histologic features
Numerous osteoclasts evenly distributed in a background of plump spindle cells, osteoclasts (multinucleated giant cells) are reactive, osteoblast progenitor cells are neoplastic (express high levels of RANKL)
40
Giant cell tumor of bone syndromes
None
41
Ewing sarcoma definition
Malignant, high grade sarcoma
42
Ewing sarcoma age and sex
Most under the age of 20, males affected more often than females
43
Ewing sarcoma locations
Diaphysis of long bones and pelvic bones
44
Ewing sarcoma gross appearance
“Onion skin” appearance of bone
45
Ewing sarcoma histologic features
Small round blue cell tumor (undifferentiated blastic appearing cells), often shows membranous reactivity for CD99 (MYC) in immunohistochemistry
46
Ewing sarcoma syndromes
None
47
Fibrous dysplasia definition
Benign bone lesion that some consider a localized developmental arrest
48
Fibrous dysplasia age and sex
Adolescence (before epiphysis closes), males and females equally affected
49
Fibrous dysplasia locations
Knee, ribs, skull, gnathic, humerus, pelvic bones (pelvis in polyostotic only), can be any bone
50
Fibrous dysplasia gross appearance
The normal components of bone are present, but do not differentiate into mature structures
51
Fibrous dysplasia histologic features
Circumscribed intramedullary nodule of “Chinese character” or alphabet soup of woven bone spicules set in a fibrous matrix, cartilage present in 20% of cases
52
Fibrous dysplasia syndromes
Polyostotic (one side of the body), Mazabraud syndrome, McCune-Albright syndrome
53
Effects of metastases to bone
Pathologic fractures, factors released locally by tumors (such as RANKL) lead to lytic lesions or other factors that lead to increased reactive density (sclerotic lesions), bone pain, osteoporosis (tumor-induced), hypercalcemia
54
Osteosarcoma mutations
CDKN2A, Rb1, p53, MDM2 CDK4
55
Ewing sarcoma mutations
FLI-1-EWS or ERG-EWS, t(11;22), t(21;22)
56
Chondrosarcoma mutations
EXT1 or EXT2 (with MHE), IDH1 or IDH2 (with Ollier’s/Maffucci), CDKN2A
57
Osteochondroma mutations
EXT1 or EXT2
58
Osteoid osteoma/osteoblastoma mutations
Unknown
59
Enchondroma mutations
IDH1 or IDH2
60
Giant cell tumor of bone mutations
H3F3A
61
Fibrous dysplasia mutations
GNAS1

MSCT (28 decks)

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