13 Ortho/soft tissue Pathology

Question 1

What is the #1 cause of bone cancer?

Answer 1

metastasis

Question 2

where do most primary bone tumors form?

Answer 2

at the metaphasis

Question 3

Which bones do osteomas generally target?

Answer 3

bones of the skull and face.

Question 4

where do most primary bone tumors form?

Answer 4

at the metaphyses

Question 5

which type of tumor is this describing: pediatric bone tumor that is generally small?

Answer 5

Osteoid osteoma

Question 6

Know this about Oseoid osteoma (4 things)?

Answer 6

1) lesions cause night pain
2) Respond to NSAIDS/aspirin
3) occur at the metaphysis
4) small

Question 7

Osteoblastoma is very similar to osteoid osteoma. The differences are that osteoblastoma…(3)?

Answer 7

1) Larger than osteoid osteoma (>2cm)
2 Tends to localize to vertibre (vs long bone metaphyses)
3) not helped by NSAIDS

Question 8

which tumor is all of the above:

1) a malignant mesenchymal tumor
2) produces malignant osteoid
3) predominates in children
4) associated with Paget’s disease

Answer 8

Osteosarcoma

Question 9

How do you treat osteosarcoma?

Answer 9

chemotherapy followed by resection.

Question 10

what does it mean to be a responder?

Answer 10

It is generally talking about osteosarcoma and the fact that some people respond to the chemotherapy treatment (90%) Those who respond have a much higher long term survival rate.

Question 11

What 4 things define an Enchondroma?

Answer 11

1) benign tumor of hyaline cartilage
2) small in size
3) well circumscribed
4) usually involves tubular bones of the hand.

Question 12

What is an osteochondroma?

Answer 12

bony outgrowths with a cartilaginous cap.

Question 13

What is the worst case scenario for an osteochondroma?

Answer 13

they can rarely undergo malignant transformation to a chondrosarcoma.

Question 14

what 4 characteristics define a chondroblastoma?

Answer 14

1) cartilaginous tumor
2) occurs in young persons
3) forms at epiphysis
4) looks like chicken wire on histology

Question 15

T/F Chondrosarcomas are adult cartilage forming sarcomas defined by permeative growth.

Answer 15

True

Question 16

Do high grade chondrosarcomas have a high metastatic risk?

Answer 16

Yes very high

Question 17

T/F It is often difficult to tell the difference between an enchondroma and osteosarcoma on histology?

Answer 17

true

Question 18

What do you see on histology of a De-differentiated chondrosarcoma?

Answer 18

an abrupt transformation of well differentiated chondrosarcoma to a high grade sarcoma that cannot be specifically identified to a certain tissue type.

Question 19

How do you treat giant cell tumors? do they tend to reoccur?

Answer 19

lesions are treated by curetage

they commonly reoccur

Question 20

what 4 characteristics describe giant cell tumors?

Answer 20

1) large tumors
2) destructive
3) epiphysial based
4) composed of sheets of mononuclear cells mixed with giant cells.

Question 21

what is another name for Ewings sarcoma?

Answer 21

Primitive neuroectodermal tumor

Question 22

what drives the formation of Ewings sarcoma?

Answer 22

reciprocal translocations of chromosomes 11 and 22 involving EWSR 1 and ETS TF’s.

Question 23

T/F CD99 and (MIC 2) markers can be used with IHC to diagnose Ewings sarcoma?

Answer 23

True these help to make the diagnosis but do not solidify the Dx.

Question 24

T/F Multiagent chemotherapy followed by surgery cures about 20% of the Ewing sarcoma cases?

Answer 24

False, it cures closer to 2/3 of the patients.

Question 25

which 2 types of carcinoma metastases are osteoblastic? (for our purposes here)

Answer 25

1) breast cancer

2) prostate cancer

Question 26

which type of carcinoma metastases is mixed? (osteoblastic and osteolytic)

Answer 26

1) Lung

Question 27

which 2 types of carcinoma metastasis are osteolytic?

Answer 27

1) Thyroid

2) Kidney