Benign & Malignant Bone Tumours Flashcards

1
Q

State at least 3 differences between benign and malignant bone tumours

A
Benign = no periosteal reaction, malignant = acute periosteal reaction
Benign = thick endosteal reaction, malignant = broad border between lesion and normal bone
Benign = well-developed bone formation, malignant = varied bone formation
Benign = intraosseus and even calcification, malignant = extraosseus and irregular calcification
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2
Q

Describe the acute periosteal reaction seen in malignant bone tumours

A

Cortex showing Codman’s triangle (triangular area of new subperiosteal bone created when the periosteum is raised away from the bone), onion skin, sunburst

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3
Q

State the typical age of onset of osteosarcoma

A

Adolescence

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4
Q

State the typical age of onset of Ewing’s sarcoma

A

<20 years

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5
Q

State the typical age of onset of giant cell tumours

A

20-40 years

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6
Q

State the typical age of onset of chondrosarcoma

A

> 40 years

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7
Q

State the most common site of osteosarcoma

A

Knee

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8
Q

State the most common site of giant cell tumours

A

Epiphysis of knee

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9
Q

State the most common sites of Ewing’s sarcoma

A

Long bones, pelvis

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10
Q

State the most common sites of chondrosarcomas

A

Axial skeleton, femur, tibia, pelvis

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11
Q

Describe the histological appearance of osteosarcoma

A

Malignant mesenchymal cells, positive for ALP

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12
Q

Describe the histological appearance of chondrosarcoma

A

Malignant chondrocytes

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13
Q

Describe the histological appearance of Ewing’s sarcoma

A

Sheets of small round cells positive for CD99. Genetic analysis shows t(11;22)

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14
Q

Describe the histological appearance of giant cell tumours

A

Osteoclast-type multinucleate giant cells on background of spindle or ovoid cells

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15
Q

Describe the x-ray appearance of osteosarcoma

A

Elevated periosteum (Codman’s triangle), sunburst appearance

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16
Q

Describe the x-ray appearance of chondrosarcoma

A

Lytic lesion with fluffy calcification

17
Q

Describe the x-ray appearance of Ewing’s sarcoma

A

Onion skinning of periosteum

18
Q

Describe the x-ray appearance of giant cell tumours

A

Lytic or lucent lesions right up to the articular surface

19
Q

State the most common sites of osteoid osteoma

A

Tibial diaphysis, proximal femur

20
Q

State the most common sites of osteoma

A

Head and neck

21
Q

State the most common sites of enchondroma

22
Q

State the most common sites of osteochondroma

A

Metaphysis of long bones near tendon attachment sites

23
Q

State the most common site of fibrous dysplasia

24
Q

Name 4 malignant bone tumours

A

Osteosarcoma, chondrosarcoma, Ewin’s sarcoma, giant cell tumour (borderline malignant)

25
Name at least 4 benign bone tumours
Osteoid osteoma, osteoma, endochondroma, osteochondroma, fibrous dysplasia, simple bone cyst, osteoblastoma
26
Describe osteoid osteoma
Small benign bone forming lesion causing pain at night, relieved by aspirin. Histology shows normal bone
27
Define osteoma
Bony outgrowths attached to normal bone. Histology shows normal bone
28
Define Gardner syndrome
Multiple osteomas, gastrointestinal polyps, and epidermoid cysts
29
Define enchondroma
Benign tumours of cartilage. Histology shows normal cartilage
30
Define Maffuci's syndrome
Multiple enchondromas and haemangiomas
31
Define osteochondroma
Cartilage capped bony outgrowrh
32
Define diaphyseal aclasis
Hereditary multiple exostoses with short stature and bone deformities
33
Define fibrous dysplasia
Replacement of bone by fibrous tissue. 'Chinese letters' (misshapen bone trabeculae) on histology
34
Describe the features of Albright syndrome
Polyostotic fibrous dysplasia with café au lait spots and precocious puberty
35
Describe the x-ray appearance of osteoid osteoma
Radiolucent nidus with sclerotic rim - Bullseye appearance
36
Describe the x-ray appearance of enchondroma
Lytic lesion with cotton wool calcification. O ring sign
37
Describe the x-ray appearance of osteochondroma
Well defined bony protuberance, cartilage capped - mushroom appearance
38
Describe the x-ray appearance of fibrous dysplasia
Soap bubble osteolysis, Shepherd's crook deformity
39
Describe the x-ray appearance of osteoblastoma
Speckled mineralisation