Bone tumors & cysts

Question 1

Are most primary bone tumors benign or malignant

Answer 1

Benign

Question 2

How are most benign tumors diagnosed

Answer 2

Xray

Question 3

What characteristics will be seen on an xray with a malignant bone tumor

Answer 3

poorly defined borders
cortical destruction
moth-eaten
Extend into soft tissue
Speculated periostea reaction

Question 4

What characteristics will a benign tumor have on an xray

Answer 4

Well defined borders
Sclerotic border
No cortical destruction
No soft tissue extension

Question 5

What are examples of PRIMARY bone cancers

Answer 5

Multiple myeloma
osteosarcoma
Ewing’s sarcoma
Chondrosarcoma

Question 6

What is the most common cause of bone tumors in adults

Answer 6

Metastatic cancer via hematogenous spread

Question 7

What are common primary sources for bone tumors

Answer 7

Lungs
Breast
Prostate
Kidney
Thyroid

Question 8

What is the most common complaint of a bone tumor

Answer 8

Pain that develops over weeks

Question 9

What diagnostic studies can be done for bone tumors

Answer 9

Xray
Bone scan
PET scan
MRI
CT

Question 10

What is a lytic lesion

Answer 10

Lesions that destroy bone material

Question 11

What is a blastic lesion

Answer 11

Fills the bone with extra cells

Question 12

What will a lytic lesion look like on an Xray

Answer 12

Black hole in the bone

Question 13

What will a blastic lesion look like on an xray

Answer 13

Abnormal white area

Question 14

What type of imaging is useful for staging with bone tumors

Answer 14

Bone scan

Question 15

When is a CT scan used for bone tumors

Answer 15

Guide for biopsies

Question 16

What is the most primary malignant tumor in pediatrics

Answer 16

Osteosarcoma

Question 17

When are osteosarcomas generally seen in children

Answer 17

During an adolescent growth spurt

Question 18

What are some risk factors associated with osteosarcoma’s

Answer 18

Pagets disease (in older adults)
Previous radiation / chemotherapy
Inherited condition

*most have no risk factors

Question 19

Where are osteosarcomas found in the body

Answer 19

Metaphysis of long bones
-distal femur
-proximal tibia
-proximal humerus

Question 20

How will osteosarcomas present in kids

Answer 20

Pain developing over several months
large / tender soft tissue mass

Question 21

How will an osteosarcoma look on an xray

Answer 21

moth eaten
sunburst appearance / hair on end
cuff of new bone formation at edge of soft tissue

Question 22

What is Codman’s triangle

Answer 22

Cuff of new bone formation at the edge of the soft tissue mass

Question 23

What will alkaline phosphate look like in a positive osteosarcoma workup

Answer 23

Increase in advanced disease

Question 24

What will happen with LDH in a positive osteosarcoma workup

Answer 24

Increase with advanced disease

Question 25

How is an official osteosarcoma diagnosis made

Answer 25

Biopsy

Question 26

How are osteosarcomas treated

Answer 26

Surgery and chemo

Question 27

What are osteoid forming tumors

Answer 27

Osteoid osteoma osteoblastoma

Question 28

What are cartilage forming bone tumors

Answer 28

Osteochondroma Enchondroma

Question 29

What are bone cysts

Answer 29

Simple (unicameral) Aneurysmal

Question 30

What are fibrous bone lesions

Answer 30

Fibrous dysplasia

Question 31

What is the most common benign bone tumor

Answer 31

Osteochondroma

Question 32

What age range are osteochondromas seen in most often

Answer 32

10-20y/o

Question 33

Where are osteochondromas usually seen

Answer 33

Around the knee and proximal humerus

Question 34

What is a tell-tale sign of an osteochondroma

Answer 34

Bone spur near the growth plate but growing away from it

Question 35

What presentation will you see with an osteochondroma

Answer 35

Painless mass pain from compression of nearby structures decreased ROM fractures

Question 36

How do you usually treat osteochondromas

Answer 36

observation

Question 37

What is a noncancerous bone tumor that begins in the cartilage

Answer 37

Endochondroma

Question 38

What is the most common type of hand tumor

Answer 38

endochondroma

Question 39

What condition is described as normal bone marrow being replaced with fibrous tissue

Answer 39

Fibrous dysplasia of bone

Question 40

What is the effect fibrous dysplasia has on the bone

Answer 40

The bone formation becomes weak and prone to expansion

Question 41

What gene is fibrous bone dysplasia related to

Answer 41

GNAS1 gene mutation

Question 42

What is a bone cyst

Answer 42

fluid filled cavity in the bone

Question 43

Which type of bone are usually effected by bone cysts

Answer 43

Long bones -humerus -femur

Question 44

10% of patients with a unicameral bone cyst have what sign on xray

Answer 44

fallen fragment