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Tri 6 - Tumors > 4. Osteosarcoma > Flashcards

4. Osteosarcoma Flashcards

1
Q

Undifferentiated connective tissue and forms of neoplastic osteoid

A

Central Osteosarcoma

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2
Q

other types of osteosarcomas

A
  • Multicentric
  • Parosteal
  • Secondary
  • Extraosseous
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3
Q

Second m/c primary malignant bone tumor

A

Central Osteosarcoma

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4
Q

20% of all primary bone tumors, mostly in 10-25 year olds.

A

Central Osteosarcoma

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5
Q

Painful swelling at site of lesion (85%), with weight loss, fever, and cachexia

A

Central Osteosarcoma

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6
Q

May take ______ or longer to DX the central osteosarcoma tumor

A

6 months

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7
Q

Central osteosarcomas likes ____ bones,

A

long

primarily knee and shoulder

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8
Q

• 58% of Central osteosarcomas tumors occur around the ____.

A

knee

Typically located in metaphysis

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9
Q

m/c affected structure in spine from osteosarcoma

A

Vertebral body

comp. Fx

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10
Q

Secondary Osteosarcoma arise in Paget’s bone at __ %

A

44

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11
Q

If patient has Paget’s disease measure -__________ as a baseline study

A

alkaline

phosphatase

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12
Q

Will Alkaline Phosphatase
levels return to normal with removal of
tumor?

A

yes

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13
Q

__ % of Central osteosarcomas are neoplastic sclerotic bone, __ % are Purely lytic
and __ % are Mixed.

A

50, 25, 25

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14
Q

Pulmonary metastasis in osteosarcoma via hematogenous

route

A

Cannonball Metastases

ossfified

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15
Q

Cannonball metastases represents

A

sarcomatous pulmonary bone growths

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16
Q

Common subpleural nodules that have undergone

excavation –> rupture

A

Spontaneous Pneumothorax

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17
Q

Skeletal Metastasis may occur, called

A

Skip lesions

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18
Q

75% of Central Osteosarcomas are in

A

metaphyses of long bones

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19
Q

Central Osteosarcomas are m/c at the
•
•

A

distal end of femur

and Proximal tibia and humerus

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20
Q

what usually acts as barrier to spread?

A

Physis

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21
Q
  • Focal lesion in metaphysis
  • Mottled, permeative lesion
  • Poorly defined zone of transition
  • cortical distruption
A

Central Osteosarcoma

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22
Q

Dense ivory or sclerotic lesion filling medullary

space

A

Central Osteosarcoma

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23
Q

Spiculated or Sunburst periosteal reaction

in soft tissue and occasionally see Codman’s Triangles

A

Central Osteosarcoma

24
Q

Ill-defined permeative mixed lytic/blastic lesion

can cross the growth plate

A

Osteosarcoma

25
Q

soft tissue mass and spiculated periosteal reaction indicates

A

rapid growth

26
Q

seen with large sclerotic

lesions

A

Cumulous cloud formation

27
Q

Large soft tissue mass formation that may contain

A

ossification

28
Q

Amputation if accessible and there is no…

Radiotherapy for local pain control

A

metastasis

29
Q

Average time between recognition of pulmonary

disease and death is

A

6 months

30
Q

Lytic presentation is rapidly

A

fatal

31
Q

radiograph of osteosarcoma of distal femoral shaft

A
  • aggressive periosteal
    changes
  • Codman triangles
  • soft tissue mass
32
Q

Sagittal T1-weighted MRI osteosarcoma

A 
- abnormal
signal intensity is present throughout
the visible shaft and metaphysis
- growth plate has limited
extension of the tumor
- Cortical destruction
33
Q

Radiograph of femur with osteosarcoma shows

a typical

A

Codman triangle

34
Q

Mixed sclerotic/lytic primary bone

lesion at the metaphysis with pathological fracture

A

central Osteosarcoma

35
Q
  • Cystic expansile lesion of the distal metadiaphysis that abuts the epiphyseal plate
  • intermediate signal on T1, and high on T2 images
A

central Osteosarcoma

36
Q

Rare, Independent lesions occuring simultaneously

A

Multicentric Osteosarcoma

37
Q

Multicentric Osteosarcoma occur in what age group?

A

5-10

38
Q
  • primary lesions
    with Rapidly fatal course
  • blastic lesions which increase alkaline phosphatase
  • Pulmonary metastasis occurs early
A

Multicentric Osteosarcoma

39
Q
  • Multiple blastic lesions
  • Bilateral and fairly symmetric
  • Metaphyseal
A

Multicentric

Osteosarcoma

40
Q

Slow growing well-differentiated osteosarcoma located on bone surface in juxtacortical location
within periosteum in 30-50 yo

A

Parosteal Osteosarcoma

41
Q

50% of Parosteal Osteosarcomas occur where?

A

posterior surface of distal femur

42
Q

Average size of Parosteal Osteosarcoma

A

10 cm

43
Q
  • Lobulated, sessile, bony mass
    with broad based attachment to bone
  • Cleavage plane = 1-3mm
A

Parosteal Osteosarcoma

44
Q

helpful imaging for Parosteal Osteosarcoma?

A

CT

45
Q

DDx for Parosteal Osteosarcoma

A

Myositis Ossificans Traumatica (MOT)

46
Q

Parosteal Osteosarcoma

vs Myositis Ossificans Traumatica (MOT)

A

Sarcomas are denser centrally grows over time (exact opposite for MOT)

47
Q

Malignant degeneration of benign disorders to osteosarcoma

A

Secondary Osteosarcoma

48
Q

who is susceptible to Secondary Osteosarcomas

A

Watch Dial Painters Ingested radium

(10-15 years later)

49
Q

Secondary Osteosarcoma looks like osteosarcoma with the

A

Permeative, motheaten, periosteal rxn, soft tissue mass

50
Q

In 1926, _____ was considered a

miracle elixir

A

radium

51
Q

avg latent period for Post-radiation Sarcoma

A

15

52
Q

used for Angiography in 1950’s

A

Thorotrast Injection

53
Q

Large soft tissue mass not adjacent to bone that m/c affects the thigh in 30-50 yo

A

Extraosseous Osteosarcoma

54
Q

Common pulmonary metastasis in

A

Extraosseous Osteosarcoma

55
Q

Non-contrast CT of the chest showing multiple, subcentimeter, calcified pulmonary nodules consistent with

A

metastatic Paget’s sarcoma

Tri 6 - Tumors (12 decks)

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