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**2.Part II - Updated Crozer > 10-Bone tumors > Flashcards

10-Bone tumors Flashcards

1
Q

What are the different patterns of bone destruction?

name it increasing malignancy.

A

geographic (benign)
moth-eaten
permeative (most malignant)

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2
Q

Describe the geographic pattern of bone destruction.

A
  • least destructive, slowly developing, usually benign or low-grade malignancy
  • *well-defined zone of transition that separates the lesion from normal appearing bone
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3
Q

What is the most common benign primary bone tumor?

A

osteochondroma

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4
Q

what is the most common malignant primary bone tumor?

A

multiple myeloma

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5
Q

describe the permeative pattern of bone destruction.

A
  • most aggressive and rapidly progressive malignant process
  • *zone of transition is poorly defined and is very wide
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6
Q

name the malignant bone tumors of the foot.

A
  • chondrosarcoma
  • osteosarcoma
  • periosteal sarcoma
  • ewings sarcoma
  • fibrosarcoma
  • multiple myeloma
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7
Q

describe the moth-eaten pattern of bone destruction.

A
  • is a more rapidly destructive process than geographic;
  • has an intermediate zone of transition that is wide and less well-defined
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8
Q

name the benign bone tumors of the foot.

A

*mnemonic: FOG MACHINES

  • fibrous dysplasia
  • osteochondroma
  • giant cell tumor
  • myeloma
  • aneurysmal bone cyst
  • chondroblastoma, chondromyxoid fibroma, clear cell
  • hemangioma
  • infection
  • non-ossifying fibroma
  • eosinophilic granuloma, enchondroma, epidermal
  • inclusion cyst
  • solitary bone cyst
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9
Q

what are the different patterns of periosteal reactions

A
  • single layer- benign but sometimes malignant
  • onion skin- malignant, multiple layers of periosteum
  • sunburst- spiculated rays
  • hair on end- parallel rays
  • codman triangle- triangular elevation of periosteum
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10
Q

what are the most common cancers that metastasize to the foot?

A
  • breast
  • prostate
  • lung
  • kidney
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11
Q

what bone tumors do not form matrix?

A

“BEG” to see the Matrix (but can’t form it)

  • bone cysts
  • ewings sarcoma
  • giant cell tumor
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12
Q

what primary bone tumors are more frequent in females?

A

“GAP” tumors are more common in females

  • giant cell tumor
  • ABC (aneurysmal bone cyst)
  • parosteal osteosarcoma
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13
Q

Name some bone tumors that are located in the epiphysis.

A

“ECG”

  • chondroblastoma
  • giant cell tumor (forms in metaphysis though)
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14
Q

name some bone tumors found in the metaphysis.

A

“FACE UP GMO”

  • non-ossifying fibroma
  • aneurysmal bone cyst
  • chondrosarcoma
  • enchondroma (also diaphyseal)
  • unicameral bone cyst
  • parosteal osteosarcoma
  • osteochodnroma
  • giant cell tumor (extends into epiphysis)
  • medullary osteosarcoma
  • parosteal osteosarcoma
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15
Q

name some bone tumors found in the diaphysis.

A

“EE, POO”

  • osteoid osteoma
  • osteoblastoma
  • enchondroma (also metaphyseal)
  • ewings sarcoma (also meta-diaphysis)
  • periosteal osteosarcoma
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16
Q

name some bone tumors that are centrally located.

A

“Central in the EU”

  • enchondroma
  • unicameral bone cyst
17
Q

name some bone tumors found in the cortex of bone.

A

“OF cortex”

  • osteoid osteoma
  • non-ossifying fibroma
18
Q

name some bone tumors that are found eccentrically located in the medullary canal.

A

“Eccentric giant old con”

  • giant cell tumor
  • chondrosarcoma
  • osteosarcoma
19
Q

name some bone tumors that are found in the periosteum.

A
  • osteochondroma
  • periosteal osteosarcoma
20
Q

what are characteristics of an osteoid osteoma?

A
  • benign, osteolytic lesion with central nidus (<1 cm) that may have calcifications
  • 1st to 2nd decades of life
  • Dull pain, worse at night, relieved with ASA
21
Q

what are characteristics of osteoblastoma?

A
  • “giant osteoid osteoma”
  • benign tumor that may become malignant
  • osteolytic lesion with well-circumscribed nidus (>1.5cm) that may have multiple calcifications
  • occurs in 2nd to 3rd decades of life
  • less symptomatic than osteoid osteoma, pain not relieved by ASA
22
Q

what are the characteristics of an enchondroma?

A
  • benign, well-defined intramedullary cartilaginous lesion
  • painless swelling unless pathologic fracture
  • geographic lesions w/ punctate calcified matrix
  • occurs in 3rd to 4th decades of life
23
Q

what is Ollier disease?

A
  • multiple enchondromatosis
  • may become malignant
  • occurs in 1st decade of life
24
Q

what is maffuccis disease?

A
  • multiple enchondromas with soft tissue hemangiomas
  • most become malignant
  • 1st decade of life
25
Q

what are characteristics of a chondroblastoma?

A
  • benign, geographic , osteolytic lesion w/ sclerotic margins
  • occurs in 2nd to 3rd decade of life
  • pain and joint effusion
26
Q

what are characterisitcs of an osteochondroma?

A
  • most common benign primary bone tumor
  • cartilage-capped, hyperpalstic bone pointing away from the joint
  • occurs in 2nd to 4th decades of life
  • suspect malignant transformation with growth after skeletal maturity, pain, or cap >2cm
27
Q

what are the characteristics of a non-ossifying fibroma?

A
  • benign CT lesion with fibrous replacement of bone
  • expansive, radiolucent, medullary lesions
  • 1st to 2nd decades of life
  • lesions typically resolve with age
  • do not biopsy
28
Q

what are characteristics of a fibrous dysplasia?

A
  • benign, geographic, fibro-osseous lesion with ground glass matrix
  • presents with deformity
  • sometimes painful secondary to fracture
29
Q

what are characteristics of a unicameral bone cyst (UBC)?

A
  • benign, geographic, medullary lesion that is fluid-filled
  • commonly found in calcaneus
  • occurs in 1st to 2nd decades of life
  • asymptomatic until fx
  • fallen fragment sign- pathologic fx in which cortex lies within lesion
30
Q

what are characteristics of an aneurysmal bone cyst (ABC)?

A
  • benign, expansile, lytic lesion with blood-filleld cavities
  • may extend into soft tissue
  • fluid-fluid levels seen on MRI
  • occurs in 1st to 3rd decades of life
  • more common in females
  • painful, especially with pathologic fractures
31
Q

what are the characteristics of giant cell (GC) tumor?

A
  • benign but locally aggressive
  • lytic lesion with ground glass, “soap-bubble appearance”
  • may destroy cortex and have soft tissue mass
  • more common in females
  • 3rd to 4th decades of life
  • painful
32
Q

what are characteristics of a multiple myeloma?

A
  • most common primary malignant bone tumor
  • punched out lesions or diffusely osteopenic with hair-on
  • end radiating spicules
  • affect 45-80 y/o
  • painful w/ weakness or neurologic sx
  • bence-jones protein found within urine
33
Q

what are characteristics of an osteosarcoma?

A
  • *most common primary malignant bone tumor
  • sunburst periosteal reaction with codman triangle and cloud-like, dense bone formation
  • occurs in 2nd to 3rd decades of life
  • dull aching pain
  • if in the medullary canal–> poor prognosis
34
Q

what is the most common bone tumor associated with paget’s disease?

A

osteosarcoma

35
Q

what are characteristics of ewing sarcoma?

A
  • aggressive, permeative, lytic lesion with onion skin appearance
  • may have large soft tissue mass
  • usually under 20 y/o
  • poor prognosis
36
Q

what are characteristics of a chondrosarcoma?

A
  • malignant, moth-eaten lesion with medullary and soft tissue calcifications
  • occurs in 5th to 6th decades of life
  • painful
37
Q

what study is most useful in searching for metatstatic bone disease?

A
  • total skeletal bone scan
  • malignant lesions will show increased uptake
38
Q

differences in prognosis for osteosarcomas found in:

medullary, parosteal, and periosteal

A
  • Medullary
    • poor prognosis
  • Periosteal
    • Slightly better prognosis than medullary
  • Parosteal
    • more common in females
    • better prognosis than medullary

**2.Part II - Updated Crozer (17 decks)

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