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Crozer Keystone Residency Manual > 10-Bone tumors > Flashcards

10-Bone tumors Flashcards

1
Q

What are the different patterns of bone destruction? name it increasing malignancy.

A

geographic
moth-eaten
permeative

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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

bone cysts
ewings sarcoma
giant cell tumor

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12
Q

what primary bone tumors are more frequent in females?

A

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

chondroblastoma

giant cell tumor (forms in metaphysis though)

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14
Q

name some bone tumors found in the metaphysis.

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

name some bone tumors found in the diaphysis.

A 
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

enchondroma

unicameral bone cyst

17
Q

name some bone tumors found in the cortex of bone.

A

osteoid osteoma

non-ossifying fibroma

18
Q

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

A

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 (

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 teh 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 fo 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?

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?

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 teh characteristics of giant cell tumor?

A

benign but locally agressive
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

Crozer Keystone Residency Manual (8 decks)

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