Malignant (Ewing's and on)

Question 1

Primitive primary malignant tumor of bone derived from connective tissue framework of bone marrow

Answer 1

Ewing’s Sarcoma

Question 2

Ewing’s Sarcoma age range

Answer 2

10-25 yo peak at 15 years

Question 3

Localized pain with swelling usually palpable soft tissue mass

Answer 3

Ewing’s Sarcoma

Question 4

Only primary malignant bone tumor that

simulates an infection

Answer 4

Ewing’s Sarcoma

Question 5

Fever, Anemia, Leukocytosis, and Elevated ESR

Answer 5

Ewing’s Sarcoma

Question 6

• Permeative
• Wide zone of transition
• Laminated periosteal reaction (or spiculated)
• Codman’s Triangles
• Cortical saucerization is early sign
• Usually mixed lytic and sclerotic patterns

Answer 6

Ewing’s Sarcoma

Question 7

early sign of Ewing’s sarcoma

Answer 7

Cortical saucerization

Question 8

Cortical saucerization is due to

Answer 8

subperiosteal extension of tumor through

Haversion systems of cortex

Question 9

MC primary malignant bone tumor to metastasize to bone

Answer 9

Ewing’s Sarcoma

Question 10

Laminated periosteal

reaction seen in

Answer 10

Ewing’s

Sarcoma

Question 11

Produces varying amounts of collagen

in 30-50 yo and presents with Local pain and swelling that may refer pain to joint

Answer 11

Fibrosarcoma

Question 12

1/3 of fibrosarcoma patients present with

Answer 12

pathologic fracture

Question 13

Malignant Fibrous Histiocytoma (MFH)

aka

Answer 13

Undifferentiated Pleomorphic Osteosarcoma

UPS

Question 14

Fibrosarcomas are purely _______, with no _______

Answer 14

radiolucent, calcification

Question 15

• Highly destructive lesion
• Expansile
• Medullary in origin
• Permeative, metaphyseal
• Eccentric
• Endosteal scalloping

Answer 15

Fibrosarcoma

Question 16

A secondary Fibrosarcoma

may be caused by

Answer 16

Paget’s disease

Question 17

Fibrosarcoma

usually metastasize to

Answer 17

lung and liver

Question 18

Rare primary malignant bone tumor arising from
vestigial remnants of notochord, which have
persisted in the nucleus pulposus of the IVD

Answer 18

chordoma

Question 19

m/c location for chordoma

Answer 19

Sacrococcygeal chordoma (50%)

Question 20

chordoma can cross the

Answer 20

disc

Question 21

Sacrococcygeal Chordoma will present with

Answer 21

constipation

Question 22

– Increased intracranial pressure, and encroachment
on adjacent structures
– chronic Headache 
– Blurred vision, diplopia
– Nasal obstruction
– Cerebellar involvement

Answer 22

Spheno-Occipital Chordoma

Question 23

vertebral cordomas mc affect the __ vertebral body and spares the

Answer 23

C2, posterior elements

Question 24

Presents as localized bone lesion with Dull aching pain, not relieved by rest
but Patient feels fairly good overall

Answer 24

Non-Hodgkin’s Lymphoma

aka Reticulum Cell Sarcoma

Question 25

Non-Hodgkin’s Lymphoma Tumor begins in

Answer 25

medullary bone

Question 26

Laminated periosteal reaction and Pathological fracture is common (initial complaint)

Answer 26

Non-Hodgkin’s Lymphoma

Question 27

radiograph of 51-year-old man with left leg pain demonstrates a lytic lesion with a moth-eaten appearance centered in the mid diaphysis of the tibia

Answer 27

Non-Hodgkin’s Lymphoma

Question 28

usually more symptomatic than blastic lesions

Answer 28

Lytic lesions

Question 29

Primary site of skeletal involvement for Hodgkin’s Lymphoma of Bone

Answer 29

vertebral body

Question 30

Hodgkin’s Lymphoma of Bone is also common in

Answer 30

lower thoracic and upper lumbar spine

Question 31

10-20% of patients with Hodgkin’s lymphoma | develop

Answer 31

skeletal disease | 75% Osteolytic

Question 32

accounts for approximately 3% of malignant bone neoplasms and comprises less than 5% of all extranodal non-Hodgkin's lymphomas

Answer 32

Primary lymphoma of the bone

Question 33

initial involvement of a single bone (long) with no evidence of disease elsewhere for at least 6 months

Answer 33

primary bone lymphoma

Question 34

characterized as "mottled" or "moth-eaten" radiolucencies, | corresponding to regions of marrow and cortical replacement by lymphoma cells

Answer 34

primary lymphomas of bone

Question 35

reported in about | 60% of Primary Lymphoma of Bone cases

Answer 35

Periosteal reaction

Question 36

Primary Lymphoma of Bone enhances with

Answer 36

gadolinium contrast

Question 37

Primary Lymphoma of Bone patients generally present with

Answer 37

localized bone pain | and, less frequently, soft-tissue swelling

Question 38

Pain of an intermittent, aching nature, with localized swelling and tenderness in a 20-40 yo

Answer 38

Giant Cell Tumor

Question 39

begins in the metaphysis and extends to end of long bone to the subarticular region

Answer 39

Giant Cell Tumors

Question 40

mc spinal site for a giant cell tumor

Answer 40

Sacrum

Question 41

Quasimalignant tumor of bone

Answer 41

Giant Cell Tumors

Question 42

* Eccentric * Metaphyseal * Purely lytic (60%) * Extends to subarticular region of bone * Thinned, expanded cortex * Soap bubble

Answer 42

Giant Cell Tumor

Question 43

definitive diagnosis of a Giant Cell Tumor must be correlated by three means:

Answer 43

Radiologic, Clinical and Histologic