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)
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
3
Q
What is the most common benign primary bone tumor?
A
osteochondroma
4
Q
what is the most common malignant primary bone tumor?
A
multiple myeloma
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
6
Q
name the malignant bone tumors of the foot.
A
- chondrosarcoma
- osteosarcoma
- periosteal sarcoma
- ewings sarcoma
- fibrosarcoma
- multiple myeloma
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
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
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
10
Q
what are the most common cancers that metastasize to the foot?
A
- breast
- prostate
- lung
- kidney
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
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
13
Q
Name some bone tumors that are located in the epiphysis.
A
“ECG”
- chondroblastoma
- giant cell tumor (forms in metaphysis though)
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
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
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
what are characteristics of a **chondroblastoma**?
* benign, geographic , osteolytic lesion w/ sclerotic margins
* occurs in 2nd to 3rd decade of life
* pain and joint effusion
26
what are characterisitcs of an **osteochondroma**?
* 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
what are the characteristics of a **non-ossifying fibroma**?
* 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
what are characteristics of a **fibrous dysplasia**?
* benign, geographic, fibro-osseous lesion with ground glass matrix
* presents with deformity
* sometimes painful secondary to fracture
29
what are characteristics of a **unicameral bone cyst (UBC)**?
* 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
what are characteristics of an **aneurysmal bone cyst (ABC)**?
* 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
what are the characteristics of **giant cell (GC) tumor**?
* 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
what are characteristics of a **multiple myeloma**?
* 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 protei**n found within urine
33
what are characteristics of an **osteosarcoma**?
* **\*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
what is the most common bone tumor associated with **paget's disease?**
osteosarcoma
35
what are characteristics of **ewing sarcoma**?
* aggressive, **permeative, lytic lesion with onion skin** appearance
* may have large soft tissue mass
* usually under 20 y/o
* poor prognosis
36
what are characteristics of a **chondrosarcoma**?
* malignant, **moth-eaten lesion** with medullary and soft tissue calcifications
* occurs in 5th to 6th decades of life
* painful
37
what **study** is most useful in searching for metatstatic bone disease?
* total skeletal bone scan
* malignant lesions will show increased uptake
38
differences in prognosis for **osteosarcomas** found in:
medullary, parosteal, and periosteal
* Medullary
* poor prognosis
* Periosteal
* Slightly better prognosis than medullary
* Parosteal
* more common in females
* better prognosis than medullary
