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ORAL PATHOLOGY! > Exam 6-Neoplasms of Bone-Malignant > Flashcards

Exam 6-Neoplasms of Bone-Malignant Flashcards

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1
Q

What is the malignant bone neoplasm that originates from the bone?

A

osteosarcoma

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2
Q

What is the malignant bone neoplasm that originates from the cartilagenous tissue?

A

ChondroSarcoma

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3
Q

What are the 2 malignant bone neoplasms that originate from the bone marrow?

A

1.Ewing’s Sarcoma 2.Multiple Myeloma

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4
Q

An osteosarcoma: A malignant neoplasm of __________ cells

A

osteoblastic

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5
Q

An osteosarcoma: Produces osteoid matrix that may or may not ______

A

calcify

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6
Q

What is a malignant neoplasm of osteoblastic cells?

A

osteoSarcoma

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7
Q

These are all precursors of what malignantcy? Conventional, parosteal and Periosteal, extraskeletal,post radiation, in Pagets disease…

A

osteoSarcoma

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8
Q

In osteosarcoma entirely radiolucent lesions are simply matrix production without matrix _________

A

calcification

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9
Q

In osteosarcoma with mixed lucent-opaque lesions you just have variable degrees of matrix _________

A

calcification

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10
Q

IN osteosarcoma with densly opaque lesions it is simply a manifestation of an EXTENSIVE matrix ________

A

calcification

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11
Q

What is the MOST COMMON primary malignancy of BONE?

A

osteosarcoma

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12
Q

What % of osteosarcoma’s occur in the jaws?

A

7%

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13
Q

Osteosarcoma has a wide ____ range and WHICH sex is slightly more often affected?

A

age….males

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14
Q

Which arch is favored for the presence of osteosarcoma?

A

TRICKED YA! they are about equal in frequency

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15
Q

Osteosarcoma is usually symptomatic with Swelling and pain, _______ of adjacent teeth, and paresthesia/anesthesia

A

loosening

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16
Q

Radiographic features of osteosarc: Ill defined lesion; _____ into surrounding bone

A

BLENDS

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17
Q

What is the most emphasized worrisome radiographic feature of osteosarcoma (he repeated like 50x!!)? WHY is it so important to catch??

A

Symmetrical widening of the PDL space….May be the earliest change before the lesion is otherwise evident

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18
Q

Radiographic features of Osteosarcoma: Alveolar bone production _____ the level of the normal alveolar crest

A

ABOVE

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19
Q

Radiographic features of Osteosarcoma: Irregular root resorption or a “______” root form associated with an
irregular _______

A

“spiked”…lucency

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20
Q

The characteristic SUN-RAY/sunburst appearance is seen in WHAT PERCENT of osteosarcoma?

A

25%

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21
Q

Which characteristic of osteosarcoma is seen in 25% of them?

A

sun-burst

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22
Q

Which view of radiograph best shows osteosarcoma?

A

occlusal

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23
Q

What is the name of an osteosarcoma arising on the cortical surface rather than in an intramedullary location?

A

Juxta-Cortial Osteosarcoma

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24
Q

Which direction does a juxtacortical osteosarcoma INITALLY grow?

A

Initial growth is outward

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25
Which form of osteosarcoma has a better prognosis-osteosarcoma or juxtacortical osteosarcoma?
jusxtacortical osteosarcoma generally has a better prognosis overall
26
What are the two subtypes of juxtacortical osteosarcoma?
Par-osteal and Peri-osteal
27
What is the MAINSTAY of treatment for osteosarcoma? BUT what is a problem?
RADICAL ablative surgery...local recurrence is a major problem
28
For osteosarcoma: PREoperative __________ has improved prognosis in some studies
chemotherapy
29
In osteosarcoma: _____ lesions metastasize less frequently than long bone disease Overall survival between 30-80%
JAW
30
What is the OVERALL survival rate for osteosarcoma?
between 30-80%
31
What is the malignant bone neoplasm producing cartilage but not bone?
A ChondroSarcoma
32
A Chondrosarcoma: Cartilage matrix may show dystrophic ________ or maturation to bone...Radiographic lesions may be lucent, mixed, or opaque
calcification
33
ChondroSarcoma: A malignant bone neoplasm producing ________ but NOT _____
cartilage...NOT bone
34
What does a chondrosarcoma appear as? Radiolucent, Mixed? Radiopaque?
Yes. all.
35
ChondroSarcoma is a relatively _______ lesion in the jaws
UNUSUAL
36
In a ChondroSarcoma, ______ cartilage is largely ABSENT in the jaws
NORMAL
37
A chondroSarcoma can be a ________ remnant in the anterior maxilla
vestigial
38
Which unique area of the jaws is susceptible to ChondroSarcoma?
Condyles
39
Although there is a wide age range for ChondroSarcoma, what age group is it most found?
most people over 50...ESPECIALLY in 6-7th decades
40
Which sex is slightly more affected by ChondroSarcoma?
Males
41
Clincial signs of ChondroSarcoma: Swelling or non-expansie?
swelling
42
Clincial signs of ChondroSarcoma: Usually non-_____ but possible ________/anesthesia
non-painful...paresthesia
43
Clincial signs of ChondroSarcoma: What happens to adjacent teeth?
loosening
44
Which arch is favored in chondrosarcoma?
maxillary
45
Radiographic Features of ChondroSarcoma: how is it defined? is it symmetrical?
poorly defined, asymmetrical
46
What is the typical treatment of ChondroSarcoma?
Radical Surgical Ablation
47
About what % of chondrosarcomas metastasize?
12%
48
Why is 5 year survival not a good indicator of chondrosarcoma prognosis?
recurrence can take more than 5 years
49
New studies show chondrosarcoma to have a better prognosis than _________
osteosarcoma
50
What is the 5 year survival for chondrosarcoma?
65-90%
51
What is the 10 year survival for Chondosarcoma?
50-70%
52
What is the 15 year survival for chondrosarcoma?
slightly worse than 50-70% (the 10 yr rate)
53
What is the cell of origin for Ewings sarcoma? What is the embriological origin?
uncertain! maybe bone marrow?...embryo: neuroECTODERMAL
54
While the cell of origin for Ewing's sarcoma is uncertain, it HAS been found to be a consistent genetic defect...WHAT is the defect??
translocation of 11;22
55
Ewing's sarcoma is ___-___% of ALL primary bone tumors
6-10%
56
Which two bones account for more than HALF of all cases of Ewing's Sarcoma?
pelvic bones and femur
57
What % of Ewing's Sarcoma occurs in the jaws?
less than 3%
58
What are the 2 most common age groups for Ewing's sarcoma?
children and adolescents
59
What % of Ewing's sarcoma patients are under the age of 20?
80%
60
Ewing's sarcoma is rare under age ___ or over age ___
5...30
61
What race and gender is most common for Ewing's sarcoma?
caucasian males (male 3:2)
62
In Ewing's Sarcoma: Pain and _____ of soft tissue overlying bone ________ pain, Varies from ____ to severe
swelling...Intermittent..dull
63
What two signs of teeth and sensation are COMMON in Ewing's sarcoma?
loosening of adjacent teeth and paresthesia
64
What are the 3 conditions we have discussed that cause loosening of the teeth?
1.osteosarcoma 2.Chondrosarcoma 3.Ewing's sarcoma
65
Which arch is more affected in Ewing's sarcoma?
mandible
66
IF Ewing's sarcoma causes systemic symptoms, what 3 are likely to take place?
1.Fever 2.leukocytosis 3.elevated ESR (erythrocyte sedimentation rate)
67
Radiograhic features of Ewing's sarcoma: Irregular, asymmetric radio______
radioLUCENT
68
Radiograhic features of Ewing's sarcoma: Ill defined ______
borders
69
Radiograhic features of Ewing's sarcoma: corticated? not corticated?
typically not corticated
70
Radiograhic features of Ewing's sarcoma: Reduplication of ______ may be present
cortex
71
Radiograhic features of Ewing's sarcoma: ________ reaction to the presence of underlying tumor
Periosteal
72
Radiograhic features of Ewing's sarcoma: Produces CHARACTERISTIC “_________” pattern
“onion skinning”
73
Radiograhic features of Ewing's sarcoma: Common in _____ bone lesions Rarely seen in _____
long bones....jaws
74
What has the prognosis of Ewing's sarcoma been historically described as?
DISMAL
75
What are the three typical treatments of Ewing's sarcoma today?
1.surgery 2.radiation 3.chemotherapy
76
What is the range of survival rates for Ewing's sarcoma?
40-80%

ORAL PATHOLOGY! (40 decks)

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