Tumors 2 Flashcards by B Burr

Osteoma: Develops on __ bones. Mass of __ bone projecting out from __. Pain or painless?

intramembranous
cortical
cortex
Painless/ Asymptomatic unless blocking sinus ostia or compressing pain sensitive structure

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Osteoma: MC locations

paranasal sinus, esp ethmoid and frontal
Calvarium
Sometimes mandible
- such as in gardne syndrome

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Osteoma: NOT common in __

maxillary

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Osteoma size

Typically

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Gardner Syndrome: Definition. Extracolonic tumors may be found in which locations?

Autosomal Dominant form of polypsis characterized by presence of multiple polyps in the colon together with tumors outside the colon.
-Extracolonic tumors may include osteomas of the skull, thyroid cancer, epidermoid cysts, fibromas, as well as desmoid tumors in 15% of cases

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Osteoid Osteoma: Histologically, a collection of highly __ osteoid tissue and __ cells surrounded by reactive __ of host bone

vascularized
giant
sclerosis

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Osteoid Osteoma: MC sites

50% in tibia and femur
10% in spine (1 of 3 benign post. arch tumors)
long bones –> metaphyseal or diaphyseal

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Osteoid Osteoma: ~__% of all bening primary bone tumors. Age: 90% Dx before __ y/o. Male to female ratio: ___

11%
25
2:1

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Osteoid Osteoma: Clinical Manifestations

Classic: Pain worse at night, relieved by aspirin
Long Hx of pain before Dx
LEsions may self-resolve over months/ years

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Osteoid Osteoma: Treatment. What may cause recurrence?

Tx with en bloc resection

Common recurrence if nidus not removed

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Osteoid Osteoma: Lesion size

Radioluscent nidus is the lesion

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Osteoblastoma: Histological twin to __ __. Clinical Manifestations?

Osteoid osteoma

Long Hx of pain
Larger, more expansile lesion

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Osteoblastoma: Sites

30-50% in post arch of spine
30% in long bones
-femur and tibia MC
-Diaphyseal/ metaphysial location

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Osteoblastoma: Tx

Surgical Resection

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Osteoblastoma: X ray characteristics

Expansile, geographic

may be big: 2-12 cm., may have stippled calcification
Often sclerotic border and sharp transition zone
usually lacks reactive dense reactive sclerosis of oesteoid osteoma

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Osteosarcoma: __ most common primary malignancy of bone. __ of all primary malignancies of bone.

2nd

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Osteosarcoma: __-shaped __ cells, osteoid and intercellular __ material.

Spindle
stromal
collagenous

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Osteosarcoma: __% of cases between __-__ years old. Male to female ratio?

75%
10-25
2:1

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Osteosarcoma: Characteristics? Lab confirmations?

Local pain, often with enlarging mass, swelling and redness
elevated serum alkaline phosphatase

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Osteosarcoma: Subtypes

Parosteal
Periosteal
Multicentric

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Osteosarcoma: MC sites

Knee and proximal humerus- reported almost everywhere

-metaphysis

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Osteosarcoma: Rarely found where?

Spine (5-7%)

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Osteosarcoma: X-ray patterns: __% are sclerotic. __% are lytic. __% are mixed pattern. X-ray characteristics?

50
25
25
-Soft tissue mass with calcification and/or ossification
-classically sunburst or spiculated
-permeative or motheaten lysis

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Osteosarcoma: Tx

Amputation and chemotherapy

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Osteosarcoma: Secondary osteosarcoma may develop from malignant degeneration of __, __, or following __ therapy of __ lesion

Paget's HME radiation benign

Parosteal Osteosarcoma: AKA ___ ___. Typical age group?

Juxtacortical Sarcoma | 2nd-4th decade

Parosteal Osteosarcoma: MC sites?

Almost exclusively long bones | -92% in femur, tibia, and humerus; most remaining in fibular, radius, and ulna

Parosteal Osteosarcoma: Charasteristics

- Tumor grows along/around bone - String Sign: radiolucency between tumor and adjacent cortex - Daughter masses

Periosteal Osteogenic Sarcoma has a __-__, __ matrix. Tumor does not outgrow __

non-homogenous spiculated base

Parosteal Osteosarcoma: __-like ossification posterior to distal __ is characteristic

cloud | femur

Enchondroma: ~__% of all benign bone tumors. MC sites?

``` 10 50% occur in small bones of hands Femur (14%) Humerus (13%) Ribs (13%) ```

Enchondroma: Most common benign bone tumor of __. NOT common in __ __ or __

Hands distal phalanges Carpals

Enchondroma: Pain? The closer to the __ skeleton, the more likely the lesion may be or become __.

Little to no pain unless pathological fx axial malignant

Enchondromatosis: AKA? Associated with presence of multiple ___ (usually affecting ONE side of the body) and is considered a __, rather than __ process.

Ollier's Disease endochondromata dysplasia Neoplastic

Enchondroma: X ray characteristics

``` Geographic, radiolucent expansile lesion Sharp zone of transition Matrix may calcify -rings and broken rings -Flocculent ```

Enchondromatosis: Types?

``` Acral Form (H/F only) -Ray form Unilateral Form (ollier's) -Generalized Oligotrophic -few lesions, primarily near joints ```

Maffucci's Syndrome Definition:

Enchondromatosis and the presence of soft tissue hemangiomas

Osteochondroma: Osseous projection from the cortex with a cartilagenous __. Thought to arise from isolated __ cells. MC __ bone tumor.

cap physeal benign- 50% of all reported benign bone tumors

Osteochondroma: MC sites?

``` -predilicts long bones 50% in lower extremity, esp femur and tibia 18% in humerus Unusual, but reported in spine -matephyseal ```

Osteochondroma: MC age? Stops growing when adjacent __ closes. Becomes malignant __% of the time. Typically asymptomatic unless...

``` physis 1 fx or other trauma pressure on adjacent nerve/vessel Adventitious bursa develops due to friction on overlying muscle/ tendon ```

Osteochondroma: 2 types

Pedunculated- (with stalk): point away from adjacent joint | Sessile: broad-based

Hereditary Multiple Exostosis: AKAs? Hereditary __ dominant trait characterized by multiple ___ scattered throughout the skeleton. Unlike the solitary variety, the osteochondromata seen in this condition are predisposed to __ degeneration

Diaphysel Aclasis or Osteochondromatosis autosomal osteochondromata malignant

Chondroblastoma: AKA? Considered rare. Ages?

-Codman's Tumor | 10-25 peak, wide range reported

Chondroblastoma: Clinical manifestations

Joint pain and swelling | Typically painful, but may be quiscent for extended periods

Chondroblastoma: MC sites?

``` Long bones -femur (33%) (distal) tibia (18%) (proximal) Humerus (20%) (proximal) -Subarticular -geographic, well-defined -often sclerotic border ```

Chondroblastoma X-ray

- minimal expansion | - calcification of matrix in 50%

Chondroblastoma Tx?

Curettage presents with insidious onset hip pain

Chondrosarcoma: Malignant lesion of ___ origin. Approximately __% of all primary malignant bone tumors. Next most common to __.

chondroblastic 10 osteosarcoma

Chondrosarcoma Age range

50% >40 y/o | remaining 50% in 20-40 range

Chondrosarcoma MC sites

Inominate (22%) Proximal Femur (22%) Ribs (14%)

Chondrosarcoma clinical signs

``` Palpable hard mass may be present slow growing- often develops over years low grade, local pain metastasizes late Males>Females 2:1 ```

Chondrosarcoma Tx

Local excision or amputation

Chondrosarcma MC sites

``` Prox Femur and pelvis- 50% Shoulder 13% Ribs 15% Long Tubular Bones 45% -soft tissue mass common popcorn or rings of broken rings Expansile geographic lesion ```

Giant Cell tumor AKA ___. What do the gradings means?

Osteoclastoma Grade 1- Benign Lesions Grade 2- Intermediate 3- Frankly Malignant

Giant cell tumor: __% are benign. __% of all primary bone tumors. __-__% of all primary malignant bone tumors

80 15 5-8

Giant cell tumor clinical

Typically painful with local swelling males = females Tx: Curette and pack -will recur commonly if not copletely removed subarticular location complicates surgical resection

Giant Cell tumor MC sites

Femur (distal) > radius (distal) > Humerus (proximal) 8% sacral -geographic and expansile -matrix purely lytic (60%) or soapbubble (40%)

Giant cell tumor age

MC in 20-40 year range (75%)

Hemangioma: Hamartomatous proliferation of thin-walled __ or engorged vascular __ (cavernous type) enveloped in __ stroma

capillaries sinuses fibrous

Hemangioma MC sites

Rare anywhere except spine and calvarium

Hemangioma MC ages

Adult: increased incidence as age advances

Hemangioma Clinical

ususally asymptomatic

Classic appearance of hemangioma

Corduroy Stripe appearance - almost always involves the body; may extend to pedicles, TVPs, etc. - does not commonly expand bone - pathological fx not common

Hemangioma of skull appearance

"Wagon Wheel" appearance- coarsened traneculae pattern throughout matrix -typically rounded-ovoid geographic lesion with sharp zone of transition

Tumors 2 Flashcards

(64 cards)