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Skeletal Radiology B > 9.) Benign Bone Forming Tumors > Flashcards

9.) Benign Bone Forming Tumors Flashcards

1
Q

What do some consider an osteoma to be?

A

A hamartoma

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2
Q

What is a hamartoma?

A

Histiologically normal tissue in an abnormal condition

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3
Q

Where do osteomas develop?

A

On intramembranous bones

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4
Q

What would be the differential diagnosis of a mass of cortical bone projecting out from the cortex?

A

Bone island inside the medullary canal

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5
Q

What is an osteoma?

A

Homogeneously dense, painless mass

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6
Q

What are the 3 most common locations of an osteoma?

A
  1. ) Calvarium
  2. ) Paranasal sinuses
  3. ) Mandible (sometimes)
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7
Q

What paranasal sinuses are osteomas most commonly found?

A

Ethmoid and frontal

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8
Q

What paranasal sinus are osteomas not commonly found?

A

Maxillary

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9
Q

What is the aka for Gardner Syndrome?

A

Familial colorectal polyposis

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10
Q

What is Gardner Syndrome?

A

An autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon

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11
Q

Where are 5 possible locations from the notes of the extracolonic tumors in Gardner Syndrome?

A
  1. ) Osteomas of the skull
  2. ) Thyroid cancer
  3. ) Epidermoid cysts
  4. ) Fibromas
  5. ) Desmoid tumors
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12
Q

What percent of Gardner Syndrome affected individuals experience an occurrence of desmoid tumors?

A

15%

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13
Q

What are 3 characteristics of osteomas on x-rays?

A

1.) Typically

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14
Q

What is an osteoid osteoma?

A

A collection of highly vascularlized osteoid tissue and giant cells surrounded by reactive sclerosis of host bone

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15
Q

Where are osteoid osteomas most commonly found?

A

50% in tibia and femur
10% in spine
Long bones

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16
Q

What are the 3 benign posterior arch tumors?

A
  1. ) Osteoid Osteoma
  2. )
  3. )
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17
Q

Where are osteoid osteomas found in long bones?

A

Metaphyseal or diaphyseal

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18
Q

Osteoid osteomas make up what percent of all benign primary bone tumors?

A

11%

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19
Q

95% of individuals with osteoid osteomas are diagnosed before what age?

A

25

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20
Q

What is the male to female ratio of those with osteoid osteomas?

A

2:1

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21
Q

What are 3 clinical findings of osteoid osteomas?

A
  1. ) Classic “pain worse at night, relieved by aspirin”
  2. ) Typically long history of pain before diagnosis (months-years)
  3. ) Lesions may self-resolve over months/years
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22
Q

How are osteoid osteomas treated?

A

En bloc resection

23
Q

What needs to occur in order to avoid an common osteoid osteoma reoccurred?

A

Nidus must be removed

24
Q

What are 5 x-ray findings of osteoid osteoma?

A
  1. ) Radiolucent nidus is the lesion

2. )

25
Q

What are 3 possible locations of an osteoid osteoma?

A
  1. ) Subperiosteal
  2. ) Intracortical
  3. ) Intramedullary
26
Q

What is the histological twin to osteoid osteomas?

A

Osteoblastoma

27
Q

What are 2 clinical findings of an osteoblastoma?

A
  1. ) Long history of pain (typically months-years)

2. ) Larger, more expansile lesion

28
Q

Where are osteoblastomas most commonly found?

A
  1. ) 30-50% in the posterior arch of the spine

2. ) 30% in long bones

29
Q

What are the most common long bones to find osteoblastomas?

A

Femur and tibia

30
Q

What part of the long bone are osteoblastomas found?

A

Diaphyseal and metadiaphyseal

31
Q

What is the treatment for an osteoblastoma?

A

Surgical resection

32
Q

What are the 5 x-ray findings of osteoblastomas?

A
  1. ) Expansile, geographic lesion
  2. ) May be big; 2-12 cm in diameter
  3. ) Matrix lucent, but may have stippled calcification
  4. ) Often with sclerotic border and sharp transition zone
  5. ) Usually lacks reactive dense reactive sclerosis of the osteoid osteoma
33
Q

What is the second most common primary malignancy of bone?

A

Osteosarcoma

34
Q

Osteosarcomas is what percent of all primary malignancies of bone?

A

20%

35
Q

What is the histology of the osteosarcoma?

A

Spindle-shaped stromal cells, osteoid and intercellular collagenous material

36
Q

75% of osteosarcoma cases occur between what ages?

A

10-25 years

37
Q

What is the male to female ratio of the osteosarcoma?

A

2:1

38
Q

What are 5 clinical findings of osteosarcomas?

A
  1. ) Local pain
  2. ) Enlarging mass
  3. ) Swelling
  4. ) Redness
  5. ) Elevated serum alkaline phosphatase
39
Q

What are the 3 “conventional” or most common subtypes of osteosarcomas?

A
  1. ) Parosteal osteosarcoma
  2. ) Periosteal osteosarcoma
  3. ) Multicentric osteosarcoma
40
Q

Where is the osteosarcoma most commonly found?

A

Knees and proximal humerus (but reported almost everywhere)

41
Q

What part of the long bone are osteosarcomas found?

A

Metaphysis

42
Q

What percent of osteosarcomas are found in the spine?

A

5-7%

43
Q

What are the 3 basic patterns of osteosarcomas?

A

50% sclerotic
25% lytic
25% mixed

44
Q

What are 5 x-ray findings of osteosarcomas?

A
  1. ) Soft tissue mass with calcification and/or ossification
  2. ) Periosteal reaction is classically Sunburst or spiculated
  3. ) Premeative or moth-eaten lysis
  4. ) Bone to bone metastasis is not common but may occur
  5. ) Multiple primaries rare, but reported
45
Q

What is the treatment for osteosarcomas?

A

Amputation and chemo

46
Q

What is the survival rate of osteosarcomas?

A

20%

47
Q

Secondary osteosarcoma may develop from what 3 things?

A
  1. ) Paget’s disease
  2. ) HME
  3. ) Following radiation therapy of benign lesions
48
Q

What is the aka for Parosteal osteosarcoma?

A

Juxtacortical sarcoma

49
Q

What are 5 clinical findings of a parosteal oseosarcoma?

A
  1. ) Slower growing and less aggressive than typical osteosarcoma
  2. ) Older age group than typical osteosarcoma (2nd-4th decades)
  3. ) Mild; hard local mass/swelling fixed to a bone
  4. ) Variable length of symptoms but typically 2-6 months
  5. ) Alkaline phosphate and other labs often WNL
50
Q

Parosteal osteosarcomas almost exclusively affects what bones?

A

Long bones

51
Q

92% of parosteal osteosarcomas are found in what 3 locations?

A
  1. ) Femur
  2. ) Tibia
  3. ) Humerus
52
Q

8% of parosteal osteosarcomas are found in what 3 locations?

A
  1. ) Fibula
  2. ) Radius
  3. ) Ulna
53
Q

What are the 2 basic types of juxtacortical sarcomas?

A
  1. ) Parosteal osteosarcoma

2. ) Parosteal osteogenic sarcoma

54
Q

How are the 2 juxtacortical sarcomas differentiated?

A

Based on relative amounts of fibrous, cartilage and osteoid tissue present

Skeletal Radiology B (17 decks)

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