Tumors 2

Question 1

Osteoma:

Answer 1

Homogenously dense, painless mass

Question 2

Common locations of OSTEOMA:

Answer 2

1-Calvarium
2-Paranasal sinuses (esp. ethmoid & frontal; NOT common in maxillary)
3-sometimes seen in Mandible (Gardner synd. =mult. osteomas + colonic polyposis

Question 3

Gardner Syndrome:
aka?
is an __ dominant form of polyposis characterized by the presence of multiple __ in the __ together with tumors outside the colon.
The extracolonic tumors may include __ of the skull, __ cancer, __ cysts, Fibromas, as well as the occurrence of desmoid tumors in approx. __% of affected individuals.

Answer 3

• aka: familial colorectal polypsis
• Autosomal
• polyps
• colon
• osteomas
• thyroid
• epidermoid
• 15%

Question 4

Osteoma projects from:

Answer 4

internal table of skull

Question 5

Osteoma on Xray:

Answer 5

-typically

Question 6

Osteoid Osteoma:

Answer 6

histologically, a collection of highly vascularized osteoid tissue and giant cells surrounded by reactive sclerosis of host bone

Question 7

Osteoid Osteoma sites:

Answer 7

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

Question 8

Osteoid Osteoma:
\_\_% of all benign primary bone tumors 
age:
sex:
clinical: classic=
typically long \_\_ of pain b4 dx. 
lesions may \_\_-\_\_ over months/years
treated w/\_\_ \_\_ resection
common recurrence if \_\_ not removed.

Answer 8

• 11%
• 90% dx b4 age 25
• males>females 2:1
• classic= “pain worse at night, relieved by aspirin”
• long history
• self-resolve
• en bloc
• nidus

Question 9

Osteoid Osteoma on Xray:

Answer 9

-radiolucent nidus is the lesion (

Question 10

Osteoid Osteoma is one of 3 primary bone tumors that predilicts the __ elements of the __.

Answer 10

• posterior

- spine

Question 11

Osteoblastoma:

Answer 11

histological twin to osteoid osteoma

Question 12

Osteoblastoma clinical:

Answer 12

• long hx of pain; typically mos./yrs.

- larger, more expansile lesion

Question 13

Osteoblastoma sites:

& treatment:

Answer 13

• 30-50% in posterior arch of spine
• 30% in long bones (femur & tibia most common; diaphyseal/metadiaphyseal location)
• treatment=surgical resection

Question 14

Osteoblastoma Xray:

Answer 14

• expansile, geographic lesion
• may be big: 2-12 cm dia.
• matrix lucent, but may have strippled calcification
• often with sclerotic border and sharp transition zone
• usually lacks reactive dense reactive sclerosis of osteoid osteoma

Question 15

Osteosarcoma incidence:

Answer 15

• second most common primary malignancy of bone

- 20% of all primary malignancies of bone

Question 16

Osteosarcoma histological:

Answer 16

-spindle-shaped stromal cells, osteoid and intercellular collagenous material

Question 17

Osteosarcoma age & sex:

Answer 17

• 75% of cases between 10-25 years

- 2:1 male>female

Question 18

Osteosarcoma characterized by:

& treatment:

Answer 18

• local pain, often with enlarging mass, swelling and redness
• treatment= elevated serum alkaline phosphatase

Question 19

Osteosarcoma subtypes:

Answer 19

“conventional” most common

• parosteal
• periosteal
• multicentric

Question 20

osteosarcoma sites:

Answer 20

most common: knee and proximal humerus

-reported almost everywhere

Question 21

osteosarcoma location:

Answer 21

• metaphysis

- rare (5-7%) in spine

Question 22

Osteosarcoma on Xray:

Answer 22

basic patterns:

• 50% are sclerotic
• 25% lytic
• 25% mixed pattern
• soft tissue mass with calcification and/or ossification

Question 23

Osteosarcoma on Xray, periosteal reaction:

Answer 23

classically:

• “sunburst”
• “spiculated”
• possible: permeative or moth-eaten bone lysis

Question 24

Osteosarcoma Treatment:

Answer 24

amputation + chemo

Question 25

Osteosarcoma survival:

Answer 25

• survival rates were dismal (20%); recent improvement due to more effective meds
• secondary osteosarcoma may develop from malignant degeneration of Paget’s, HME or following radiation therapy of benign lesion

Question 26

Osteosarcoma:

bone to bone __ is not common, but may occur.

Answer 26

-metastasis

multiple primaries rare, but reported- multi centric osteosarc