230. Neoplasia Flashcards

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1
Q

List the major tumors of the bone, cartilage, bone marrow

A

Bone: Osteoma, Osteoid Osteoma, Osteoblastoma, Osteosarcoma (only Malignant)

Cartilage: Chondroma, Osteochondroma, Chrondroblastoma, Chrondromyxoid fibroma, Chondrosarcoma (only malignant)

Bone Marrow: Myeloma, Malignant Lymphoma (both malignant)

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2
Q

Most common bone tumor

Most common primary tumor of bone

A

Most common = metastases from other site (usually osteolytic)

Primary = Multiple myeloma, then osteosarcoma

Primary usually M>F

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3
Q

Osteoma
(Type of tumor, age, location, imaging)

What is Gardner Syndrome?

A

Benign solitary tumor
Middle age
Surface of facial bone, slow growing
Dense compact bone on xray

Gardner: multiple osteomas on face

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4
Q
Osteoid Osteoma
(type, age/sex, presentation, location, imaging, tx)
A
Small benign tumor of osteoblasts (<2cm)
Young adults <25; M>F
Nocturnal bone pain, relieved by aspirin
Cortex of Long Bones (femur)
Xray: zone of sclerotic lamellar bone surrounding lucent focus (nidus)
tx: surgery, radiofrequency ablation
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5
Q

Osteoblastoma

type, location, presentation

A

Bigger (>2cm) benign tumor of osteoblasts
Usually affects vertebrae
Does not respond to NSAIDs

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6
Q

Osteochondroma

type, age/sex, location, imaging, prognosis

A

MOST COMMON BENIGN BONE TUMOR
Males <25 years old
tumor in bone + cartilage cap, arises from metaphysis growth plate of distal femur/proximal tibia
XR: bony stalk with cartilagenous cap continuous with bone medulla (like ice cream cone)
Prognosis: good, 1-2% recur though, but rarely progress to malignant

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7
Q

Chondroma

type, age/sex, location, imaging, histo

A

Benign intramedullary cartilagenous tumor
2-4th decade, M=F
Medulla of small bones of hands/feet
XR: well-circumscribed lucency with cartilage matrix calcification (Arc + ring = encondral bone formation at periphery of tumor)
Histo: nodules of mature cartilage in fatty bone marrow - mature collagen and low cellularity

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8
Q

Giant Cell Tumor of Bone

type, age/sex, location, imaging, tx, histo

A

Benign giant cell tumor
20-40 years, F>M
Epiphysis of long bone (distal femur/proximal tibia - KNEE)
XR: “soap-bubble” lytic lesion in epiphysis
Tx: excision, may recur
Hist: losts of giant cells (many nuclei)

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9
Q

Fibrous Dysplasia (type, age, location patterns, imaging, histo)

A

Benign tumor linked to localized developmental arrest
bone components do not differentiate to mature structures
In first 3 decades of life
Monostotic: femur most common - stabilizes at puberty
Polyostotic: may also have endocrine dysfx
XR: expansile lesion with variable internal density (ground-glass)
Histo: irregular elements of woven bone with no osteoblast rimming (immature)

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10
Q

Osteosarcoma (type, age/sex, location, imaging, histo, tx)

A

Malignant proliferation of osteoblasts
Bimodal age: 10-20yrs and >65 years
M>F
Metaphysis of long bone (Knee - DF, PT, or proximal humerus)
XR: Codman Triangle = new subperiosteal bone raises periosteum away from bone (“sunburst rxn”)
Histo: very cellular/pleiomorphic, malignant cells directly produce osteoid/woven bone
Tx: pre-op chemo, surgery excision, prosthesis/post-op chemo

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11
Q

Chondrosarcoma (type, age/sex, location, imaging, histo)

A

malignant tumor of chondrocytes
5-7th decates, M>F
Central skeleton (hip, shoulder, rib) & central part of bone (medullary cavity)
lobulated lesion with cartilage matrix calcification (arc and ring), NO periosteal reaction
Histo: hypercellular cartilage doesnt look like cartilage

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12
Q

Ewing Sarcoma (type, mechanism, age/sex, location, imaging, histo, tx)

A

Malignant neuroectodermal tumor of bone
t(11;22) chormosome translocation - fusion protein EWS-FLI1
Young age <20, M>F
Diaphysis of long bones (femur>pelvis/rib)
XR: ill defined lytic lesion, Periosteal reaction “onion skin” with soft tissue extension
Histo: focal necrosis, diffuse proliferation of small rounded neoplastic cells
Tx: chemotherapy (like osteosarcoma)

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13
Q

Multiple myeloma (type, age/sex, sx, location, xray, histo, tx)

A

clonal proliferation of plasma cells (IgG)
Most common primary malignant tumor of bone
M>F, age > 40 (peak 65-70)
sx: CRAB (hyperCa, Renal insufficiency, Anemia, lytic Bone lesion)
vertebral, ribs, skull, pelvis, femur
XR: punched out lytic lesions
Histo: proliferation of plasma cells (perinuclear hof), kappa-restricted shows clonal nature
Tx: chemo and radio therapy (poor prognosis)

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