18.2 Bone Tumors Flashcards
What are osteomas? Where, anatomically, are they most likely to be found?
Benign tumors of the bone that most commonly arise on the surface of facial bones
What GI disease is associated with the development of osteomas?
Gardner’s syndrome
What is osteoid osteoma? What are the cells that form this? Where, anatomically, are these usually found, and where in the bone are they?
- Benign tumor of osteoblasts surrounded by a rim of reactive bone
- Arises in the cortex of long bones, usually near the diaphysis
What is the age range that osteoid osteomas usually occur in?
Less than 25 years old
What are the radiological findings of osteoid osteomas?
Bony mass, with a radiolucent core
reflects the osteoid in the center, and the reactive bone around it
What is the usualy presentation of osteoid osteomas? What can be used to treat it?
Bone pain relieved by ASA
Which is relieved by ASA: osteoid osteomas, or osteoblastomas?
Osteoid osteomas
What are the cells that comprise an osteoblastoma? Where, anatomically, does it usually arise? How big are they, usually?
- Proliferation of osteoblasts
- Larger than 2 cm
- Vertebrae
What is the size difference between osteoid osteomas and osteoblastomas?
Osteoblastomas are greater than 2 cm, while osteoid osteomas are usually smaller
What are the usual s/sx of osteoblastomas?
Bone pain unrelieved by ASA
What is the most common benign tumor of bone?
Osteochondroma
What is an osteochondroma?
Tumor of bone with an overlying cartilage cap, that usually arises as a lateral projection of a growth plate
True or false: an osteochondroma is contiguous with the underlying growth plate
True
What is a major consequence of untreated osteochondroma
Overlying cartilage can transform into a chondrosarcoma
What are the cells that comprise osteosarcomas? What is the age that is usually affected? Where in the bony / bone do they develop?
- Malignant proliferation of osteoblasts
- Teenagers and the elderly
- Metaphysis of long bones (femur or proximal tibia)
What are three major risk factors for the development of osteosarcomas?
- Rb
- Paget’s disease of bone
- Radiation exposure
What is the usual cause of osteosarcomas in the elderly? What is different about the prognosis of these, relative to younger onset disease?
Usually d/t PDB or other disease processes, and carries a worse prognosis
What are the usual presenting s/sx of osteosarcomas?
Pathologic fracture or bone pain
What are the two classic x-ray findings of osteosarcoma?
- Codman’s triangle–raising of the periosteum of the bone, with underlying separation of the cortex
- Star burst appearance of bone d/t spicules of bone being produced
What are the histological findings of osteosarcomas?
Malignant cells surrounded by osteoid
What are the cells that comprise giant cell tumors? In whom does this usually occur?
- Comprised of multinucleated giant cells
- Occurs in young women
What is the one primary bone lesion that arises in the epiphysis of long bones?
Giant cell tumors
What is the classic appearance of giant cell tumors on x-ray?
Soap-bubble appearance
What is the prognosis for giant cell tumors?
Locally aggressive, and may recur
Where do giant cell tumors usually arise, anatomically speaking?
Epiphysis of long bones
What are Ewing Sarcomas? Where in the body / bone do they usually arise?
- Malignant proliferation of poorly differentiated cells from neuroectoderm
- Diaphysis of long bones inside the medullary cavity
What is the age range and gender of the usual Ewing sarcoma pt?
Young male
What is the classic x-ray appearance of Ewing Sarcoma? What causes this?
- Onion skin appearance
- Reaction of the periosteum d/t pressure from internal Ewing
What are the stains that are positive for Ewing sarcoma?
CD99 and S100
What are the histological findings of Ewing’s sarcoma?
Lots of small round blue cells
What is the translocation that produces Ewing’s sarcoma?
11:22
11 + 22 = 33, Ewing’s jersey number”
What is the prognosis of Ewing’s sarcoma?
Often presents with mets, but is responsive to chemo
Where do chondromas usually occur in the body?
Fingers / hands
What are chondromas, generally? Where do they arise relative to bone?
Benign tumor of cartilage that arise in the medulla of bone
What is a chondrosarcomas, and where in the body / bone do these usually arise?
- Malignant cartilage forming tumor
- Arises in the medulla of the pelvis of central skeleton
What are the two metastatic tumors of bone that are osteoblastic?
Prostate
Breast
Which are most common, primary or mets to bone?
Mets
Are most mets to bone osteolytic or osteoblastic?
Osteolytic
What is the difference between osteolytic and osteoblastic lesions?
Osteolytic produces punched out appearance, while osteoblastic causes sclerosis of the bone
