Exam 3 Tumors Flashcards
(115 cards)
1
Q
What tumor crosses the physis?
A
giant cell tumor
2
Q
What tumor is in the epiphysis?
A
chondroblastoma
3
Q
Age of occurrence for Ewing’s Sarcoma?
A
10-25
4
Q
Age of occurrence for osteosarcoma?
A
10-25
5
Q
Age of occurrence for Giant Cell Tumor?
A
20-40
6
Q
Age of occurrence for chondrosarcoma?
A
55-70
7
Q
Age of occurrence for myeloma?
A
50-70
8
Q
75% of all malignancies?
A
metastatic disease
9
Q
MC primary malignant tumor in in adults?
A
multiple myeloma
10
Q
MC primary malignant tumor in kids?
A
osteosarcoma
11
Q
MC benign osseous tumor?
A
osteochondroma
12
Q
MC benign spinal tumor?
A
hemangioma
13
Q
More aggressive tumors have ________ zone of transition.
A
longer
14
Q
Most aggressive forms of periosteal reaction?
A
Codman’s Triangle
15
Q
Tumors with cartilage matrix 5:
A
- enchondroma
- osteochondroma
- chondroblastoma
- chondromyxoid fibroma
- chondrosarcoma
16
Q
Tumors with osseous matrix 5:
A
- osteoma
- osteoblastoma
- osteochondroma
- osteoid osteoma
- osteosarcoma
17
Q
Tumors with fibrous matrix 6:
A
- fibrous dysplasia
- desmoplastic fibroma
- non-ossifying fibroma
- fibrous cortical defect
- ossifying fibroma
- fibrosarcoma
18
Q
bone expansion typically primary, >6cm, numbers of lesions, periosteal reaction, presence of ST
A
primary neoplasia
19
Q
MC sites of metastatic bone disease:
A
breast, lung, prostate, kidney, thyroid, and bowel
20
Q
Types of metastatic bone disease:
A
blastic, lytic, mixed, or expansile
21
Q
MC primary site for mets in females:
A
breast (70%) 80% is lytic and 10% is blastic
22
Q
MC primary site for metastasis in males:
A
prostate (60%) 80% blastic
23
Q
MC pathway of metastasis?
A
hematogenous dissemination (blood)
24
Q
MC secondary sites of metastasis:
A
Spine 40% Ribs and sternum 28% Pelvis and sacrum 12% Proximal extremities 10% Skull 10%
25
Where is metastasis rare?
distal to knees and elbows
26
Radiographic features of vertebral metastasis:
ivory vertebra, pedicle destruction, pathologic collapse, focal osteoporosis of a body, and malignant schmorl's node formation
27
Solitary ivory vertebra most likely indicates:
1. Paget's
2. Hodgkin's lymphoma
3. Osteoblastic metastasis
28
What lab is helpful when checking for lymphoma?
CBC, BCP, and ESR
29
What lab is helpful when checking for Paget's?
BCP for alkaline phosphatase
30
What lab is helpful when checking for blastic mets?
BCP to include alkaline and acid phosphatase and PSA
31
MRI characteristics of metastasis:
T1 sensitive: low
| T2 variable: high
32
Primary malignant neoplasia accounts for ______ of all malignancies:
30%
33
Age for multiple myeloma:
50-70
34
Round cell tumors:
- Ewing's
- Non-Hodgkin's lymphoma
- Multiple myeloma
35
Clinical features of multiple myeloma:
pain, unexplained wt loss, cachexia, bacterial respiratory infections, anemia, renal disease, respiratory disease, deossification of bone, abnormal serum and urine proteins
36
Lab findings for multiple myeloma:
elevated ESR, thrombocytopenia, rouleaux formation, increased serum Ca, normal to increased serum phosphorus, M Spike on protein electrophoresis
37
Skeletal locations for multiple myeloma:
vertebrae: thoracic and lumbar, pelvis, skull, ribs, clavicle, scapula, femur, and humerus
38
What is solitary plasmacytoma?
localized form of plasma cell proliferation
39
What areas does solitary plasmacytoma prefer?
vertebra>pelvis>skull>sternum>ribs
40
Soap bubbly, highly expansile lesion:
solitary plasmacytoma
41
Bone scan on multiple myeloma:
may be normal
42
Rain drop skull:
multiple myeloma
43
Multiple myeloma may spare the _________ more than lytic mets:
pedicles
44
5 yr survival multiple myeloma:
20%
45
Primary malignant tumor of undifferentiated CT which forms neoplastic osteoid:
osteosarcoma
46
2nd MC primary malignant bone tumor:
osteosarcoma
47
MC primary malignant bone tumor in children and young adults:
osteosarcoma
48
Age for osteosarcoma:
10-25 and 60+
49
Clinical presentation for osteosarcoma:
painful swelling 85% of the time
50
Skeletal location of osteosarcoma:
distal femur: 40%
proximal tibia: 16%
proximal humerus: 15%
(75% in metaphysis next to growth plate)
(cylindrical bones under 30 and flat bones over 50)
51
Mets from osteosarcoma to:
lungs
52
Rad findings for osteosarcoma:
- ill defined, dense sclerotic lesion >5cm fills medullary space
- moth eaten medullary and cortical destruction less C
- sunburst/Codmans
- large ST mass w tumor
53
Cumulus cloud, cannonball:
osteosarcoma
54
What films are needed with osteosarcoma:
chest films/CT
55
Secondary osteosarcoma:
Paget's, Ollier's, Ionizing radiation, Polystotic fibrous dysplasia, Hereditary multiple exostosis
56
Third most common primary malignant bone tumor:
chondrosarcoma
57
Secondary chondrosarcoma:
complication of preexisting skeletal abnormality such as osteochondroma or enchondroma
58
Age for chondrosarcoma:
40-60
59
Common locations for chondrosarcoma:
proximal humerus, neck of femur, ribs, sternum, pelvis
60
Popcorn matrix calcification:
chondrosarcoma (also fluffy, stippled, cotton wool, etc)
61
4th most common primary malignant bone tumor:
Ewing's Sarcoma
62
2nd most common primary malignant bone tumor in children:
Ewing's Sarcoma
63
Age for Ewing's Sarcoma:
10-25, peak at 15
64
Clinical Ewing's:
severe localized pain, palpable soft tissue mass, fever, infection
65
Only primary malignant tumor that stimulates infection:
Ewing's
66
Skeletal location for Ewing's:
long tubular bones: 60% (femur, tibia, humerus, fibula, especially under 20)
67
onion skin
Ewing's Sarcoma
68
Saucerization:
Ewing's
69
Most common primary malignancy to metastasize to bone:
Ewing's
70
Ewing's metastasis:
lung, bone, regional lymph nodes (11-30% at diagnosis, 40-45% within 2 years)
71
Ewing's 5 year survival:
60-75%
72
Giant Cell Tumor: Benign or Malignant?
quasi-malignant malignant 20% of time
73
Age for Giant Cell tumors:
20-40
74
Osseous location of GCT:
85% in long bones (distal femur, proximal tibia(50-60%), distal radius, and proximal humerus)
75
GCT tumors are more malignant in:
distal radius
76
GCT clinical:
local aching pain, malignant more in males
77
bony exostosis on external bone with a hyaline cartilage cap:
solitary osteochondroma
78
Most common benign osseous tumor:
solitary osteochondroma
79
50% of all benign tumors:
solitary osteochondroma
80
age for solitary osteochondroma:
under 20
81
Clinical solitary osteochondroma:
asymptomatic unless disturbing vessels or nerves. Painless hard mass. Pain or new growth may mean malignant
82
Osseous location solitary osteochondroma:
metaphysis of long bones: femur, tibia (50%), humerus, proximal radius
83
Growth of solitary osteochondroma stops when:
growth plate closes
84
Exostosis on solitary osteochondroma grows:
away from joint
85
Widespread solitary osteochondroma:
hereditary multiple exostosis
86
mushroom shaped peduculated bony excresence:
sessile osteochondroma
87
Hereditary multiple exostosis AKA:
diaphyseal achalasia
88
HME age:
2-10
89
Average exostosis in HME:
10
90
HME clinical:
painless hard masses, cord compression possible, malignant 5-20%(chondrosarcomas)
91
SBC age:
3-14
92
SBC location:
60-75% in proximal humerus and femur
93
Fallen fragment sign:
SBC
94
Age of aneurysmal bone cyst:
10-30 (75% below 20)
95
Clinical ABC:
acute onset of pain increasing over 6-12 weeks, may have trauma
96
Locations aneursymal bone cyst:
spine 30% (posterior anatomy)
| long bones and flat bones
97
ABC cortex:
invisible thin
98
ABCs are not:
subarticular
99
GCTs are:
subarticular
100
Age osteoblastoma:
10-20 peak
101
Osteoblastoma resembles:
osteoid osteoma
102
Clinical osteoblastoma:
dull pain of insidious onset: 84%
103
Osteoblastoma locations:
spine in 40%
long bone: 30%
small bones of hands and feet: 25%
104
Osteoid osteoma represents ______ of benign tumors
12%
105
Age osteoid osteoma:
10-25
106
Clinical findings osteoid osteoma
tender to touch, local pain in 98%, worse at night, salicylates relieve pain in most
107
Location osteoid osteoma
meta/diaphysis of long bones (73%)
108
Age enchondroma:
10-30
109
MC benign tumor of the hand
enchondroma
110
Location endochondroma:
small bones of wrist and hands: 40% (phalanges>metacarpals), long bones, usually central
111
enchondromatosis, early childhood, hand and foot deformity, multiple enchondromas
Ollier's disease
112
Age hemangiomas:
40-60
113
Signs/symptoms of hemangiomas:
asymptomatic unless spinal lesions cause stenosis and compression
114
Locations of hemangiomas:
lower thoracic and upper lumbars, calvarium (frontal)
115
Accordion, corduroy, honeycomb:
hemangioma
