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Skel Rad > B bone tumor 2 > Flashcards

B bone tumor 2 Flashcards

1
Q

what is it

A

osteoma

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2
Q

what is a hamartoma

A

histologically normal tissue in an abnormal location

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3
Q

where do osteomas develope

A

intramembranous bones

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4
Q

homogenously dense painless mass

A

osteoma

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5
Q

common locations for osteoma

A

calvarium

paranasla sinuses- esp ethmoid and frontal

*not common in maxillary

sometimes in mandible (gardener syndrome)

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6
Q

what is garender syndrome and what type of tumor is it assoccated with

A

aka familial colorectal polyposis

autosomal DOMINANT

presence of multiple polyps in colon and tumors outside the colon

extra colonic tumors: skull, thyroid cancer, epidermoid cysts, fibromas

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7
Q

projects from internal table of the skull

A

osteoma

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8
Q

usually _________radiodense and featureless

not ____________ unless blocking sinus

A

homoneously

symptomatic

frontal sinus osteoma

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9
Q

common sites for osteoid osteoma

A

50% tibia/ femur

10% spine

long bones metaphyseal or diaphyseal

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10
Q

_____% diagnosed before age 25

A

90

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11
Q

osteoid osteoma predelection

A

males 2:1

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12
Q

pain worse at night

relieved by asprin

long hx of pain before dx

self resolve over months/years

resection to remove

will reoccur if nidus not removed

A

osteoid osteoma

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13
Q

possbile locations of osteoid osteoma

A

subperosteal

intracortical

intramedullary

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14
Q

radiolucent nidus <1cm

maybe obscured by reactice sclerosis

A

osteiod osteoma

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15
Q
A

osteiod osteoma

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16
Q
A

osteiod osteoma

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17
Q
A

osteiod osteoma

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18
Q
A

osteiod osteoma

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19
Q
A

osteoid osteoma

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20
Q

one of 3 _____bone tumors that predilicts posterior elements of the spine

A

primary

osteoid osteoma

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21
Q

histological twin to osteoid osteoma

A

osteoblastoma

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22
Q

Long hx of pain; typically mos. – yrs.

´Larger, more expansile lesion

´30-50% in posterior arch of spine

´30% in long bones

´Femur and tibia most common

´Diaphyseal/metadiaphyseal location

sx

A

osteoblastoma

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23
Q

Expansile, geographic lesion

May be big; 2-12 cm dia. Matrix lucent, but may have stippled calcification

Often with sclerotic border and sharp transition zone

Usually lacks reactive dense reactive sclerosis of osteoid osteoma

A

osteoblastoma

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24
Q
A

osteoblastoma

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25
Q

young pt expansile lesion post arch

A

osteoblastoma

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26
Q
A

osteoblastoma

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27
Q
A

osteoblastoma

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28
Q

´second most common primary malignancy of bone

A

osteosarcoma

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29
Q

________% of all primary malignancies of bone-osteosarcoma

A

20

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30
Q

osteosarcoma histology

A

spindle-shaped stromal cells, osteoid and intercellular collagenous material

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31
Q

age range of osteosarcoma

A

10-25 (75%)

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32
Q

gender pedilection for osteosarcoma

A

male 2:1

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33
Q

´Characterized by local pain, often with enlarging mass, swelling and redness

´Elevated serum alkaline phosphatase

A

osteosarcoma

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34
Q

subtypes of osteosarcoma

A

“Conventional” most common

Parosteal

Periosteal

Multicentric

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35
Q

most common sites for osteosarcoma

A

knee and proximal humerus

reported almost everywhere

rare in spine

metaphysis

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36
Q

basic pattern of osteosarcoma

A

50% are sclerotic

25% lytic

25% mixed pattern

soft tissue mass with calcification and or ossification

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37
Q

Periosteal reaction classically what for osteosarcoma

A

sunburst

spiculated

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38
Q
A

osteosarcoma

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39
Q

destuctive patterns associated with osteosarcoma

A

permiative/motheaten

40
Q

bone to bone metastasis is common in osteosarcoma T/F

A

false

41
Q

treatment for osteosarcoma

A

amputation

chemo

42
Q

Secondary osteosarcoma may develop from

A

maliganant degeneration of Pagets, HME, following radiation therapy of a benign lesion

43
Q

does osteosarcoma have multiple primaries

A

no, rare

44
Q

parosteal osteosarcoma aka

A

juxtacortical sarcoma

45
Q

´Slower growing and less aggressive than typical osteosarcoma

´Older age group then typical o-sarc (2nd – 4th decades)

´Mild S/S; hard, local mass/swelling fixed to bone

´Variable length of symptoms but typically 2-6 months

Alk. Phos and other labs often WNL

A

parosteal osteosarcoma

46
Q

what area does parostal ostosarcoma affect

A

´Almost exclusively affects long bones

92% in femur, tibia and humerus ;most of remaining in fibula, radius and ulna

47
Q

2 basic types of juxtacortical sarcomas based on

A

relative amounts of fibrous, cartilage and osteoid tissue present

Parosteal osteocarcoma

Periosteal osteogenic sarcoma

48
Q

parosteal osteosarcoma has what kind of ossification?

A

cloudlike

49
Q

characteristic location of parosteal osteosarcoma

A

posterior distal femur

50
Q

most common site of enchondroma

A

50% occur in small bones of hands

Most common benign bone tumor of hands

Not common in distal phalanges or carpals

Femur (14%), humerus (13%), ribs (13%)

51
Q

Clinical:

Little/no pain unless pathological fracture

The closer to the axial skeleton, the more likely the lesion may be or become malignant

A

enchondroma

52
Q

presence of multiple enchondromata ( usually affecting one side of the body) and is considered a dysplasia, rather than neoplastic process.

A non-hereditary, non-familial condition

A

Enchondromatosis (Ollier’s Disease)

53
Q
A

Geographic, radiolucent expansile lesion

Sharp zone of transition

Matrix may calcify

“rings and broken rings”

´“flocculent”

enchondroma

54
Q
A

enchondroma

55
Q
A

enchondroma

56
Q

In long bones the d/dx should include med-ullary bone infarct

A

enchondroma

57
Q
A

enchondroma

58
Q
A

enchondromatosis

*Note the ring-like pattern of matirix calcification

59
Q
A

Enchondromatosis-Maffucchi’s Syndrome

*Note the calcified phleboliths in soft tissues

60
Q

Most common benign bone tumor

A

osteochondroma

61
Q

most common sites for osteochondroma

A

predilicts long bones

50% in lower extremity; esp femur and tibia

18% in humerus

Unusual, but reported in spine

Location- metaphyseal lesion

62
Q

´Age- develops in childhood

´Stops growing when adjacent physis closes

´Rarely (1%) become malignant;

´Late growth and/or unexplained pain suspicious

´Typically asymptomatic unless

´Fractured or otherwise traumatized

´Pressure on adjacent nerve/blood vessel

´Adventitious bursa develops due to friction on overlying muscle/tendon

A

osteochondroma

63
Q

2 types

A

osteochondroma

´Pedunculated = with stalk-point away from adjacent joint

´Sessile = broad-based

64
Q
A

osteochondroma

65
Q

An hereditary, autosomal dominant trait characterized by the presence of multiple osteochondromata scattered throughout the skeleton.

A

Hereditary Multiple Exostosis (HME)

Diaphyseal Aclasis or Osteochondromatosis

66
Q
  • “Bayonet” deformity of hand/wrist due to short ulna
  • Broad femoral metaphyses
A

Hereditary Multiple Exostosis (HME)

67
Q
A

Hereditary Multiple Exostosis (HME)

68
Q
A

Hereditary Multiple Exostosis (HME)

69
Q
A

Hereditary Multiple Exostosis (HME)

70
Q
A

Hereditary Multiple Exostosis (HME)

71
Q

•Thickened cartilagenous cap with irregular calcification may

A

indicate malignant change

Hereditary Multiple Exostosis

72
Q
A

Hereditary Multiple Exostosis

73
Q
A

Hereditary Multiple Exostosis

74
Q
A

Hereditary Multiple Exostosis

75
Q

condition in which the part of the radius bone forming the wrist joint grows abnormally resulting in the hand to be deviated towards the little finger and the palm.

A

Madelung deformity

76
Q

´“Codman’s tumor”

rare

ages 10-25

Joint pain and swelling

Typically painful, but may be quiescent for extended periods

A

Chondroblastoma

77
Q

Mild/minimal expansion

Matrix shows calcification in 50%

No periosteal reaction

D/dx = giant cell tumor

Treatment = curettage esents with insidious onset hip pain

A

chondroblastoma

78
Q
A

brodies abcess

79
Q

´Palpable, hard mass may be present

´Slow growing - often develops over years

´Low grade, local pain

´Metastasizes late

´Males > Females 2:1

´Treated with local excision or amputation

´Survival rate varies from very good in small, lower grade types to poor in large lesions with extensive local invasion

A

chondrosarcoma

80
Q

´Prox. Femur and pelvis = 50%

´Shoulder = 13%

´Ribs = 15%

´Long tubular bones = 45%

´Expansile, geographic lesion- may be large

´Soft tissue mass common

´Calcification of matrix common

´“popcorn” or “rings and broken rings”

A

chondrsarcoma

81
Q
A

chondrsarcoma

82
Q
A

chondrosarcoma

83
Q
A

chondrosarcoma

84
Q

´AKA osteoclastoma

´Considered a “quasimalignant” tumor

´Histologically graded I – III

´Grade I = benign lesions

´Grade II – intermediate

´Grade III = frankly malignant

´Histology: connective tissue stromal cells with multi-nucleated giant cells

´80% are benign

´15% of all primary benign bone tumors

´5-8% of all primary malignant bone tumors

A

giant cell

85
Q

´Typically painful (intermittently) with local swelling

´May path #

´Males = females

´Age: most in 20 – 40 yr. range (75%)

´Treatment: currette and pack

´Will reoccur commonly if not completely removed.

´Subarticular location complicates surgical resection

A

giant cell

86
Q

common sites for giant cell tumors

A

´Femur (distal) > radius (distal) >humerus (proximal)

´ 8% sacral

´Location: subarticular

´Considered a metaphyseal lesion

´Typically eccentric

´Geographic and expansile

´Matrix purely lytic (60%) or “soapbubble” (40%)

87
Q
A

giant cell

88
Q
A

giant cell

89
Q
A

Giant cell tumor

90
Q
A

Hemangioma

91
Q
A

Hemangioma

92
Q
A

Hemangioma

93
Q

bone island aka

A

solitary enostosis

94
Q

multiple bone islands =

A

Osteopoikilosis

95
Q
A

Osteopoikilosis

96
Q
A

Osteopoikilosis

97
Q

histologically what is osteoid osteoma

A

collection of highly vascularized osteoid tissue and giant cells surrounded by reactice sclerosis of host bone

Skel Rad (7 decks)

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