1.2 Bone Tumors Flashcards
Osteoma
- where usually
- associated syndrome?
- benign tumor of bone
- common on facial bones
- associated with Gardner syndrome (FAP, Fibromatosus of retroperitoneum, Osteoma)
Osteoid osteoma
- benign tumor of osteoblasts surrounded by rim of reactive bone
- presents as bony mass with osteoid core
- located in cortex of long bones
Osteoblastoma vs Osteoid osteoma
- similarities
- differences (3 ways to distinguish)
- both are osteoblast tumors
1. size: osteoblastoma is larger (>2cm vs <2cm)
2. location: osteoblastoma–vertebrae, osteoid osteoma–long bones
3. aspirin: Osteoblastoma does not respond to aspirin, Osteoid sarcoma does
Osteosarcoma
- what is it
- location
- how does it present
- malignant tumor of osteoblasts
- metaphysis of long bones, usu near knee
- presents as fracture/bone pain, no swelling
- Codman triangle (lifting of periosteum)
Codman’s triangle
- xray finding of osteosarcoma
- shows lifting of periosteum by tumor
Osteochondroma
- what is it
- location
- benign bone tumor with cartilage cap
- arises from metaphysis (growth plate) lateral projection
what is most common benign tumor of bone?
osteochondroma
Giant Cell tumor
- what is it
- location
- clinical findings
- think ‘giant soap’
- tumor of multinucleated giant cells and stromal cells
- only tumor in epiphysis, usu near knee
- “soap bubbles” on xray
Ewing sarcoma
- what is it
- location
- “go out for Ewings and onion rings”
- malignancy of neuroectoderm cells
- diaphysis
- ‘Onion skin’ on xray. Formed by sarcoma pushing out against bone; extra layers of bone are created.
Chondroma vs Chondrosarcoma
-how to differentiate
location:
chondroma–hands/feet small bones
chrondrosarcoma–pelvis or central skeleton
which bone tumors occur where?
- epiphysis
- metaphysis
- diaphysis
- epiphysis–giant cell tumor (only)
- metaphysis–osteochondroma, osteosarcoma
- diaphysis–Ewing’s sarcoma, chondrosarcoma
Which tumors are associated:
- childhood, adolescence
- young adults
- elderly
- osteosarcoma, ewing’s sarcoma
- giant cell tumor
- chondrosarcoma
osteochondroma appears in children and young adults
most common bone sarcoma?
what are the others?
- Osteosarcoma
- Ewing’s, chondrosarcoma
osteosarcoma common spreads to where?
lung via blood
osteosarcoma:
-what genetics increase risk?
- mutated Rb
2. Li-Fraumeni (mutated p53)
osteochondroma:
-what increases chances of transformation into chondrosarcoma?
- normally <1% becomes chondrosarcoma, but 40% if you have Hereditary Multiple Exostoses (HME)
- auto dom. mutation in EXT gene.
enchondroma vs periosteal chondroma
enchondroma : chondroma of intramedullary bone
periosteal: cortical surface under periosteum
Multiple chondromatosis
- presence of multiple chondromas, appears in:
1. Ollier’s disease
2. Maffucci’s syndrome (also has hemangiomas) - both caused by point mutations
Ollier’s disease
- hereditary disease
- presents with multiple enchondromas
Maffucci’s syndrome
- hereditary disease
- presents with multiple enchondromas and hemangiomas
non-ossifying fibroma
- benign bone lesion
- very common developmental cortical defect (1 in 4)
- usually heals itself
Fibrous dysplasia
- appearance on xray
- appearance histology
- associated disorder
-normal bone replaced with fibrous bone tissue
- thinned cortex
- “frosted glass” appearance of bone
- “chinese characters” of randomly oriented bone trabeculae
-McCune-Albright syndrome
-McCune-Albright syndrome
presents with:
- polyostotic fibrous dysplasia (multiple bones)
- cafe au lait spots
- endocrine problems
Ewing’s sarcoma:
etiology
11: 22 translocation
think: patrick ewing’s jersey was 33, = 11+22
