Tumors 2

Question 1

What % of neuroblastomas metastasize?

Answer 1

50%

Question 2

What % of neuroblastomas calcify?

Answer 2

66% (Yochum)

Question 3

What is the M/C abdominal tumor in a child, according to Yochum? What is the 2nd M/C?

Answer 3

1st = Neuroblastoma
2nd = Wilm's

Question 4

What is the M/C locations for a solitary plasmacytoma?

Answer 4

Mandible, ilium, vertebrae, ribs, proximal femur & scapula

Question 5

What % of osteosarcoma is radiopaque? What % is mixed? What % is lytic?

Answer 5

Sclerotic = 50%
Mixed = 25%
Lytic = 25%

Question 6

Which type of periosteal rxn is classic for ostoesarcoma?

Answer 6

Sunburst

Question 7

Osteosarcoma is most likely to mets to where?

Answer 7

Lung => cannonball mets

Question 8

What radiographic sign is present in 30% of parosteal osteosarcoma cases that separates the tumor from the cortex?

Answer 8

String sign (or cleavage plane)

Question 9

Which contrast medium was known to malignantly degenerate into secondary osteosarcoma?

Answer 9

Thorotrast

Question 10

What is the M/C location for an extraosseous osteosarcoma?

Answer 10

thigh

Question 11

True or false: pain is a reliable work up for a suspected chondrosarcoma.

Answer 11

False – often just swelling with no pain until it fx or pushes painful structures

Question 12

What is the M/C primary malignant tumor of the hand?

Answer 12

chondrosarcoma

Question 13

What is the M/C primary malignancy of the pelvis? 2nd? 3rd?

Answer 13

1st = Ewing's
2nd = Osteosarcoma
3rd = Chondrosarcoma

Question 14

What is the M/C primary malignancy of the chest wall (including sternum & scapula)?

Answer 14

Chondrosarcoma

Question 15

What is the % risk of malignant degeneration of HME?

Answer 15

20%

Question 16

What is the % risk of malignant degeneration of osteochondroma?

Answer 16

<1%

Question 17

What is the % risk of malignant degeneration of Ollier’s?

Answer 17

10%

Question 18

What is the % risk of malignant degeneration of Maffuci?

Answer 18

25%

Question 19

Histology of Ewing’s sarcoma is most similar to which other tumors?

Answer 19

Myeloma, non-Hodgkin’s lymphoma, neuroblastoma, leukemia and EG

Question 20

Younger patients who develop Ewing’s are likely to develop it where? And older patients are likely to develop it where in the skeleton?

Answer 20

Younger = peripheral
Older = axial

Question 21

Axial involvement in Ewing’s is likely to affect what region of the spine?

Answer 21

Lumbar & sacrum

Question 22

What is an early and characteristic radiographic finding seen with Ewing’s sarcoma?

Answer 22

cortical sauceriation

Question 23

What is the M/C location for bone mets from Ewing’s?

Answer 23

Spine

Can present with skip lesions => multiple lesions in one bone; also seen in osteosarcoma

Question 24

What % of patients present with a path fx as the initial complaint in fibrosarcoma?

Answer 24

33%

Question 25

Bone infarcts malignantly degenerate to which tumor?

Answer 25

Fibrosarcoma or malignant fibrous histiocytoma

Question 26

According to Yochum, which tumor is the only primary malignant bone tumor to cross the intervertebral disc and involve adjacent segments?

Answer 26

Chordoma

Question 27

Chordoma in which region of the spine is most likely to have calcification?

Answer 27

Sacrococcygeal & clivus (VB location rare)

Question 28

Which lymphoma is more likely to be painful (rather than clinically silent)?

Answer 28

Hodgkin's lymphoma (Non-hodgkin's is usually silent)

Question 29

Which form of lesion is more likely to be painful in Hodgkin's lymphoma, lytic or blastic?

Answer 29

Lytic

Question 30

Where is the M/C location for Hodgkin's lymphoma to affect?

Answer 30

Thoracolumbar region

Question 31

Where is the M/C location for an adamantinoma?

Answer 31

Anterior tibia (next M/C is jaw)

Question 32

What are the radiographic features of adamantinoma?

Answer 32

- lytic bone blister cortical appearance - sawtooth loss of cortical bone - multichambered, bubbly lesion - eggshell cortical thickening & spool-shaped bulges of cortex