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Diagnostic Imaging II Exam Three > Benign Tumors > Flashcards

Benign Tumors Flashcards

1
Q

Do most benign tumors occur early or later in life?

A

Early (before age 20)

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2
Q

Are giant cell tumors benign or malignant?

A

80% benign but 20% malignant

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3
Q

What is the age range for a giant cell tumor?

A

20-40

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4
Q

What is the male to female ratio for a GCT?

A

1:1

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5
Q

What is the most common benign tumor of the sacrum?

A

Giant cell tumor

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6
Q

What is the most common location for GCT?

A

85% in the long bones, mostly distal femur and proximal tibia, distal radius, proximal humerus

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7
Q

What is unique about the male to female ratio of GCT?

A

Females more likely when malignant

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8
Q

What is the key feature about the location of bone with GCT?

A

SUBARTICULAR ***

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9
Q

What is the most common benign osseous tumor?

A

Solitary osteochondroma (50%)

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10
Q

What is the age of occurrence for an osteochondroma?

A

Below 20

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11
Q

Which tumor is a bony exostosis on the external surface of a bone and usually is lined by a hyaline cartilage cap?

A

Solitary osteochondroma

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12
Q

What are the two types of osteochondromas?

A

1 sessile

2 pedunculated

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13
Q

Where are sessile osteochondromas commonly located?

A

Humerus and scapula

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14
Q

Where are pedunculate osteochondromas commonly located?

A

Knee, hip, ankle

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15
Q

Which type of osteochondromas has a cartilage cap?

A

Pedunculated

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16
Q

What are some of the descriptive terms used for a pedunculated osteochondroma?

A

“Coat hanger exostosis” and “cauliflower cap”

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17
Q

Osteochondromas are found in what part of a long bone?

A

Metaphysis

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18
Q

Although some locations are more common than others, generally where can osteochondromas be found?

A

Any bone formed by endochondral ossification

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19
Q

Do the exostoses of the osteochondromas tend to point toward or away from the nearby joint?

A

AWAY

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20
Q

A subcondylar process pointing in which direction from the joint is considered a normal finding?

A

TOWARD the joint

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21
Q

What is another name for hereditary multiple exostosis?

A

Diaphyseal achalasia

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22
Q

What condition is an inherited autosomal dominant condition characterized by multiple osteochondromas often causing metaphyseal overgrowth?

A

Hereditary multiple exostosis

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23
Q

When is hereditary multiple exostosis usually discovered?

A

2-10 years of age

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24
Q

What is the average number of exostoses seen with hereditary multiple exostosis?

A

10 (can be anywhere from a few to 100 though)

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25
Q

How can hereditary multiple exostosis become dangerous?

A

5-20% become malignant, possible cord compression, possible obstructive uropathy

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26
Q

What radiographic feature of the hands can be seen with hereditary multiple exostosis?

A

Shortening of the 4th and 5th metacarpals

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27
Q

What radiographic feature of the fingers and toes can be seen with hereditary multiple exostosis?

A

Supernumerary

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28
Q

What radiographic feature of the radius can be seen with hereditary multiple exostosis?

A

Madelung (bending) or bayonet deformity

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29
Q

What tumor is non-neoplastic with a fluid filled cystic cavity lined with fibrous tissue?

A

Simple bone cyst

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30
Q

What is the usually age of occurrence of a simple bone cyst?

A

3-14 (80%)

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31
Q

Are solitary bone cysts painless or painful?

A

Painless

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32
Q

When can solitary bone cysts become painful?

A

When fractured

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33
Q

Where do most simple bone cysts occur?

A

Proximal humerus and femur (60-75%)

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34
Q

What is the specific location in a bone that a simple bone cysts grows?

A

Central in the metaphysis adjacent to growth plate

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35
Q

The “fallen fragment sign” is associated with what tumor?

A

Simple bone cyst

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36
Q

What does the “truncated cone appearance” mean in reference to a simple bone cyst?

A

Will never grow wider than its length

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37
Q

How can we differentiate a GCT from a simple bone cyst?

A 
GCT = subarticular, eccentric, ages 20-40
SBC = metaphyseal, central, ages 3-14
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38
Q

What causes the fallen fragment sign seen with a simple bone cyst?

A

A piece sinks to the bottom in fluid

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39
Q

How are simple bone cysts treated?

A

Most effective = injection of steroids post drainage (but some spontaneous regress)

40
Q

What is the most common bone to be involved with an osteosarcoma?

A

Distal femur

41
Q

Which lesion is non-neoplastic and expansile containing thin-walled blood-filled cystic cavities?

A

Aneurysmal bone cyst

42
Q

What is the age range for an ABC?

A

10-30 (75% occur below the age of 20)

43
Q

What is the gender bias associated with an ABC?

A

FEMALES

44
Q

What are some neurological signs that can present with an ABC?

A

Radiculopathy or quadriplegia with spinal involvement

45
Q

What is the most common location for an ABC?

A

SPINE (with predilection for posterior elements like the spinous, lamina, pedicle, transverse)

46
Q

What flat bones are associated with an ABC?

A

Pelvis

47
Q

What the is the most aggressive of the non-neoplastic lesions?

A

Aneurysmal bone cyst

48
Q

Is an aneurysmal bone cyst typically blastic or lytic?

A

Lytic

49
Q

How does an ABC appear?

A

Eccentric with soap bubble expansion

50
Q

Which two lesions are known to be more common in females?

A

Hemangioma and ABC

51
Q

What is the most common benign tumor of the clavicle?

A

ABC

52
Q

How can an MRI differentiate between a GCT and ABC?

A

ABC would show fluid-fluid levels due to changes of blood over time

53
Q

What is the peak age for an osteoblastoma?

A

10-20

54
Q

How would a patient present with an osteoblastoma?

A

Dull pain, localized swelling, decreased range of motion, painful functional scoliosis (50%)

55
Q

What is the most common location for an osteoblastoma?

A

Spine (40%) (uniquely, the small bones of the hands and feet)

56
Q

What is the age range for an osteoid osteoma?

A

10-25

57
Q

What are the clinical features of an osteoid osteoma?

A

Local pain (up to 98%) that’s worse at night, decreased by activity and aspirin

58
Q

Osteoid osteomas are found in what specific part of bone?

A

Meta and diaphyses of long bones

59
Q

What tumor is associated with a nidus formation?

A

Osteoid osteoma

60
Q

What is a nidus?

A

Hole with a sclerotic ring

61
Q

What is the best imaging for an osteoid osteoma?

A

CT (shows hole/nidus in cortex)

62
Q

What technique can be used to remove an osteoid osteoma?

A

Radiofrequency ablation

63
Q

What is the term for a dark central area with a light gray around it as seen on a bone scan with an osteoid osteoma?

A

“Double-density sign”

64
Q

What is a common location for an osteoid osteoma even though no bone is technically exempt?

A

SPINE (14%) specifically the posterior elements of lower thoracic and upper lumbars creating the painful scoliosis

65
Q

How is the cortex affected by an osteoid osteoma which therefore differentiates it from a fibrous cortical defect?

A

THICKENING

66
Q

Osteomas are tumors that arise in what kind of overall bone?

A

Membranous (think skull)

67
Q

Are osteomas more commonly found in children or adults?

A

Adults

68
Q

Osteomas are associated with what syndrome?

A

Gardner’s

69
Q

What are common locations for osteomas?

A

Frontal and ethmoid sinuses, calvarium, mandible, nasal bones

70
Q

Enchondromas are found in what specific part of bone?

A

Medullary cavity

71
Q

What is the age of occurrence with enchondromas?

A

10-30

72
Q

Are enchondromas painful?

A

NO

73
Q

What is the most common location for enchondromas?

A

40% in the small bones of wrists and hands

74
Q

What is the most common benign tumor of the hands and feet?

A

Enchondromas

75
Q

Are enchondromas lytic or blastic?

A

Lytic

76
Q

What is the treatment for enchondromas?

A

Usually none…(no pain)

77
Q

What is the name of the condition with early childhood presentation of multiple enchondromas of the hands and feet due to nonhereditary failure of cartilage ossification?

A

Ollier’s (enchondromatosis)

78
Q

What is the name of the condition with multiple enchondromas plus multiple soft tissue hemangiomas?

A

Maffucci syndrome

79
Q

What lesion is a solitary vascular neoplasm which is slow growing and composed of newly formed capillary, cavernous, or venous blood vessels?

A

Hemangioma

80
Q

At what age do hemangiomas commonly occur?

A

During 4-5 decades

81
Q

What is the gender bias associated with hemangiomas?

A

FEMALE

82
Q

How common are hemangiomas?

A

10% of overall population

83
Q

What is the most common benign tumor of the spine?

A

Hemangioma

84
Q

When do hemangiomas become symptomatic?

A

When the expand and cause spinal stenosis and cord compression

85
Q

What is the most common location for a hemangioma?

A

Vertebral body of lower thoracics and upper lumbars, calvarium with special predilection for frontal bone

86
Q

What are the terms used to describe the trabecular changes seen with hemangiomas?

A

“Accordion”, “corduroy”, “honeycomb”

87
Q

If multiple vertebrae were seen to have the “corduroy” appearance that is seen with a hemangioma, what other condition should be looked at?

A

Osteoporosis

88
Q

The “filled soda straw appearance” and “polka dot sign” seen on CT is associated with what tumor?

A

Hemangioma

89
Q

What is the typical size of a hemangioma?

A

Less than 4 cm (round)

90
Q

What is the age of occurrence for a chondroblastoma?

A

8-59 years (LOL, no joke) with peak age of 5-25 (88%)

91
Q

When do chondroblastomas develop?

A

Before cessation of enchondral bone growth

92
Q

What is the specific location in bone for a chondroblastoma?

A

Around apophysis or epiphysis in subarticular location

93
Q

What is the most common location for a chondroblastoma?

A

Femur (2/3 found in lower extremities and keep in mind tarsal bones are a rare possibility

94
Q

What other lesion is specific to the epiphysis along with a chondroblastoma?

A

Giant cell tumor (but is completely subarticular)

95
Q

How can we differentiate between a giant cell tumor and chondroblastoma?

A 
GCT = 20-40 YOA
Chondroblastoma = 5-25 peak age

Diagnostic Imaging II Exam Three (4 decks)

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