Lec 16 Bone Tumor

Question 1

What are of bone most likely to have infection/tumor?

Answer 1

metaphysis

Question 2

Who gets an osteoid osteoma?

Answer 2

young adults < 25 yo; M > F

Question 3

What is location of osteoid osteoma?

Answer 3

in cortex of long bones

Question 4

What are characteristics of osteoid osteoma?

Answer 4

• benign, sharply demarcated osteoblastic
• < 2 cm in size
• pain at night relieved by aspirin

Question 5

What is most common primary bone malignancy?

Answer 5

osteosarcoma

Question 6

What are characteristics of osteosarcoma?

Answer 6

• tumor produces bone matrix

- present w/ pain, swelling, pathologic fracture, high alkaline phosphatase

Question 7

Who gets osteosarcoma?

Answer 7

young adults < 20; smaller peak after age 50

Question 8

What is location of osteosarcoma?

Answer 8

near sites of active bone growth = metaphysis

Question 9

Where does osteosarcoma metastasize?

Answer 9

hematogenously to lungs

Question 10

What is treatment for osteosarcoma?

Answer 10

pre-op chemo + surgery

good prognosis

Question 11

What are characteristics of osteochondroma?

Answer 11

• most common benign bone tumor
• can be solitary or multiple
• neoplastic lateral outgrowth from growth plate w/ cartilaginous cap
• rarely transforms to chondrosarcoma
• synchronously grows w/ normal epiphyseal growth plate; stops growing when skeletal maturity reached

Question 12

Who gets osteochondroma?

Answer 12

males < 25 yo

Question 13

What is osteochondromatosis?

Answer 13

familial disorder with multiple hereditary osteochondromas

autosomal dominant
have asymmetric retardation of longitudinal bone growth

manifests in adolescence and ceases in adulthood

Question 14

What is an enchondroma?

Answer 14

benign intramedullary hyaline cartilage neoplasm

Question 15

Where does enchondroma occur?

Answer 15

appendicular skeleton in medullary region

Question 16

What are characteristics of enchondroma?

Answer 16

• variable presentation: aysmptomatic, painless swelling

- can resemble chondrosarcoma

Question 17

What is enchondromatosis [ollier disease]?

Answer 17

rare non hereditary disorder of multiple intramedullary cartilaginous tumors

affected limb may be shortened or deformed; rarely progresses past puberty

may develop assocaited chondrosarcoma or osteosarcoma

Question 18

What is maffucci syndrome?

Answer 18

enchondromatosis + hemangiomas

increased susceptibility to development of sarcoma

Question 19

What is chondrosarcoma?

Answer 19

malignant mesenchymal tumor of malignant cartilaginous cells

can be primary or arise from previous enchondroma or osteosarcoma

Question 20

Where is chondrosarcoma located?

Answer 20

in medullary cavity

Question 21

Who gets chondrosarcoma?

Answer 21

men 30-60 yo [peak 55]

Question 22

What is treatment for chondrosarcoma?

Answer 22

does not respond to chemo –> must remove surgically

Question 23

What do you see in ewing sarcoma radiographically?

Answer 23

• destructive lytic lesion

- onion skin periosteal reaction

Question 24

Who gets ewing sarcoma?

Answer 24

10-15 yo; M > F

caucasians

Question 25

Where is ewing sarcoma located?

Answer 25

diaphysis of long bones

Question 26

What are characteristics of ewing sarcoma?

Answer 26

have pain in area, fever, sick = mimics osteomyeltis warm, enlarging mass from neuroectoderm --> mesenchymal cells = small round blue cel tumor; no matrix production

Question 27

What is treatment for ewing?

Answer 27

chemo, radiation, surgery

Question 28

What is a fibrous cortical defect?

Answer 28

non neoplastic intracortical proliferation of fibrous tissue and histiocytes seen in kids M > F in metaphysis

Question 29

What is a non-ossifying fibroma?

Answer 29

fibrous cortical defect 2-5 cm in adolescents expanded into medullary cavity may present w/ pathologic fracture

Question 30

What do you see on xray with non ossifying fibroma?

Answer 30

well circumscribed lytic lesion with slightly sclerotic rim | in metaphysis

Question 31

What is monostotic fibrous dysplasia?

Answer 31

single bone fibrous dysplasia | stops when growth plate closes

Question 32

What is fibrous dysplasia?

Answer 32

benign fibroosseus tumor | intramedullary proliferation of fibrous tissue + woven bone --> failure to differentiate to mature bone

Question 33

Who gets fibrous dysplasia?

Answer 33

age < 30 yo [kids and young adults]

Question 34

What are 3 types of fibrous dysplasia?

Answer 34

monostotic = single bone polystotic = multiple bones mccune albright syndrome = polyostotic FD + endocrine abnormalities [precocious puberty] + cafe au lait spots

Question 35

What are signs of mccune albright syndrome

Answer 35

polyostotic FD + endocrine abnormalities [precocious puberty] + cafe au lait spots

Question 36

What happens in polyostotic fibrous dysplasia?

Answer 36

present in young pts than monostotic; continues into adulthood have craniofacial invovlement often

Question 37

What is a giant cell tumor?

Answer 37

benign locally aggressive; usually solitary tumor around knee

Question 38

Who gets a giant cell tumor?

Answer 38

20-40 yo

Question 39

Where is giant cell tumor located?

Answer 39

epiphysis