Benign Tumors Flashcards

1
Q

osteoma occurs in what type of bone

locations

A

membranous bones

outer skull and sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how big is an osteoma

A

< 2cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe an osteoma on imaging

A

round, oval, well circumscribed

uniformly opaque

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the mc benign tumor of the nose and paranasal sinuses

A

osteoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is gardners syndrome

A

multiple osteomas
and
colonic polyps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does osteoma look like on MRI

A

low intensity on T1 and T2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

where do bone islands occur

A

anywhere

mc in epiphysis and metaphysis

not diaphysis

also not seen in skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what does bone island look like on imaging

A

discrete area of sclerosis

brush border - help ddx from blastic mets

round oval well circumscribed

long axis parallel to bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a enostoma

A

another term for bone island

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

do bone islands cause any symptoms

A

no

no pain or chance of malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what does bone island look like on MRI

how about CT

how about on bone scan

A

low intensity on T1 and T2

bright on CT

cold on bone scan unless in growth period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how big is an osteoid osteoma

A

< 1cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

osteoid osteoma most commonly occur where

in what part of the bone

A

mc in tibia or femur

also in neural arch

metaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

osteoid osteomas can induce what defect in the spine due to tumor in neural arch

A

painful rigid scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which tumor contains radiolucent nidus with surrounding sclerosis or solid periosteal reaction

A

osteoid osteoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

which tumor contains a vascular blush on MRI

A

osteoid osteoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

osteoid osteomas occur in what age range

A

10-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are the symptoms of osteoid osteoma

A

gradual onset of severe deep aching pain

worse at night!

relieved by aspirin!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what do you use to diagnose osteoid osteoma

A

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how do you treat osteoid osteoma

A

thermoregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what does osteoid osteoma show on bone scan

how about MRI

A

intense uptake

low signal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the differential diagnosis for osteoid osteoma

A

brodies abscess

  • infection (osteomyelitis) with same signs and symptoms but NO vascular blush and nidus > 1cm

osteoid osteoma is < 1cm

also brodies is cold on bone scan to differentiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

where does osteoblastoma occur

A

common in metaphysis

but loves posterior neural arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what does osteoblastoma look like on imaging

A

expansile lesion

egg shell thin cortex and matrix

maybe sclerotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the age range for osteoblastoma

A

10-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are the symptoms of osteoblastoma

A

gradual onset of pain

painful scoliosis if in posterior neural arch

pain not relieved by aspirin and not worse at night (compared to osteoid osteoma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what ROM is lost in osteoblastoma

A

loss of extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what is the differential diagnosis for osteoblastoma

A

ABC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

can osteoblastomas become malignant

A

small percentage do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what does osteoblastoma look like on bone scan

how about MRI

A

HOT

high intensity on T2 due to increase fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the treatment for osteoblastoma

A

curettage

radiation if last resort

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

where does solitary enchondromas occur in the body

A

common in metaphysis

loves small bones of hands and feet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what do solitary enchondromas look like on imaging

A

radiolucent expansile lesions

intact but thinning of the cortex

endosteal scalloping

punctate calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what may have happened if solitary enchondroma is causing pain

A

pathological fracture or malignant transformation

usually doesnt cause pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

if enchondroma becomes malignant, where is it located

A

axial skeleton

turns into chondrosarcoma when metastasizes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what age does solitary enchondromas occur in

A

10-30

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what does solitary enchondroma look like on MRI

A

low signal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what is treatment of solitary enchondroma

what about if fracture occurs

what if its close to axial spine

A

packing chips - calcium phosphate packing

implanted human bone morphogenic protein

fracture - casting and curettage

axial spine = malignant - prophylactic surgery to remove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

multiple enchondromas is called

A

olliers disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

are solitary or multiple enchondromas more likely to become malignant

A

multiple - olliers

10-50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

multiple enchondromas, hemangiomas, and phleboliths is called what

A

maffuccis syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

does solitary enchondromas, olliers, or maffuccis have the highest rate of malignancy transformation

A

maffuccis syndrome

multiple enchondromas, hemangiomas, phleboliths

transforms into chondrosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

where do chondroblastomas occur

A

only epiphysis and apophysis

knees, femur, proximal tibia, and humerus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what does chondroblastoma look like on imaging

A

radiolucent round oval lytic lesion

eccentric - located in medullary canal

internal matrix calcification because cartilaginous matrix

ring of sclerosis

solid periosteal reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what age do chrondroblastoma occur in

A

10-25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

what is also called codmans tumor

A

chondroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what is the treatment chondroblastoma

A

curettage and bone chip packing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

what does chondroblastomas look like on MRI

what does it look like on bone scan

A

low signal

hot!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is the size of chondromyxoid fibroma

A

1-10 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

chondromyxoid fibroma looks __ but it is actually __

A

look malignant

but its benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

chondromyxoid fibroma occurs in what location MC

A

proximal 1/3 of tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what does chondromyxoid fibroma look like on imaging

A

eccentric oval round lesion

endosteal scalloping

sclerosis on the medullary side of lesion

trabeculated or soap bubble appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what age group does chondromyxoid fibroma occur in

A

10-30
or
50-70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what is treatment for chondromyxoid fibroma

A

curettage or excision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

where do fibrous cortical defects MC occur

A

posterior medial distal femur**

or LE

metaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

what does fibrous cortical defect look like on imaging

A

< 1cm

lytic lesion
sclerotic rim
eccentric

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

what age range does fibrous cortical defect occur in

A

4-8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

fibrous cortical defect is symptomatic or asymptomatic

A

asymptomatic - found by accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

fibrous cortical defect may become what

A

non ossifying fibroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

non ossifying fibroma MC occurs where

A

MC in distal tibia

diametaphyseal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

what does non ossifying fibroma look like

A

2-7 cm

multilocular

lytic eccentric ovoid

dense sclerotic border on medullary side of lesion
- peripheral sclerotic border

periosteal reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

what age range does non ossifying fibroma occur in

A

8-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what is a non ossifying fibroma due to

A

faulty ossification centers - not true neoplasm

64
Q

does non ossifying fibroma cause symptoms

A

no

but could cause pain if large enough or causes fracture or stress fracture

65
Q

non ossifying fibroma may turn malignant? yes or no

A

no malignant transformation

66
Q

where does simple bone cysts occur

A

proximal humerus and femur and calcaneus

metaphysis into diaphysis

67
Q

what is a bone cyst made up of

A

fluid filled cyst with thin layer of fibrous tissue - so no matrix calcification

68
Q

what does a simple bone cyst look like on imaging

A

truncated cone or bullet shape

broad near metaphysis and narrow in diaphysis - not seen in epiphysis

cystic radiolucency

endosteal scalloping

light or incomplete septation

69
Q

what age group do bone cysts occur in

A

3-14

70
Q

if a simple bone cyst is in the ___ it is an active cysts

if it is in the __ it is an latent cyst

A

active - metaphysis

latent - diaphysis

71
Q

2/3 of bone cysts result in what

A

pathological fracture - result in fallen fragment or hinged fragment sign

72
Q

what sign is associated with bone cysts

A

fallen fragment sign - small detached floating fragment that changes position with movement

hinged fragment sign - fragment attached at one end but the other end moves with movement

  • indicates fluid on imaging
  • associated with fracture
73
Q

what imaging is used to find fluid in the bone cyst

what does it look like on imaging

A

MRI

high on T2
low on T1

74
Q

what is the size of an ABC

A

8-10 cm

75
Q

where does an ABC occur

A

metaphysis of long tubular bone (could cross growth plate)

MC in posterior neural arch

76
Q

what does ABC look like on imaging

A
eccentric 
expansile 
egg shell thinning of cortex 
soap bubble 
may cross the growth plate
77
Q

what age group does ABC occur in

A

5-20

78
Q

what is the mc benign bone tumor of the clavicle

A

ABC

79
Q

what are the symptoms of ABC

A

acute rapid progressive pain

RAPIDLY INCREASING PAIN!!!

80
Q

what is an ABC made up of

A

blood

NOT A TRUE CYST
not a aneurysm

81
Q

how to treat an ABC

A

curettage and packing

82
Q

what is the size of an intraosseous lipoma

A

2-13 cm

83
Q

where does intraosseous lipoma occur

A

metaphysis of long bones - tibia, fibula, metatarsal, calcaneus

MC in calcaneous

84
Q

if ABC is found in the posterior neural arch, what does this cause

A

stenosis and epidural mass effect

85
Q

what does intraosseous lipoma look like on imaging

A

lytic
sclerotic border
expansile
endosteal scalloping

calcific radiopaque of central necrosis - looks like doughnut or target

cockade sign - dystrophic calcification

86
Q

what age do intraosseous lipomas occur in

A

5-70

87
Q

what is the rarest benign bone tumor

A

intraosseous lipoma

88
Q

does intraosseous lipoma cause symptoms

A

no symptoms

incidental finding

89
Q

what is treatment for intraosseous lipoma

A

curettage and packing

90
Q

where do hemangiomas occur

A

MC in spine
skull - maxilla and mandible
soft tissue

91
Q

what do hemangiomas look like on imaging in the spine skull and soft tissue

A

spine - corduroy cloth appearance (thickening of horizontal trabeculae with thinning of vertical trabeculae), polka dot spine (CT or MRI)

skull - sunburst or spoke wheel appearance in skull

soft tissue - phleboliths

92
Q

where do hemangiomas occur in the skull

whats the size

A

frontal bone MC

1-7 cm round and oval

93
Q

hemangiomas occur in what age group

A

> 40

94
Q

what is the most common benign tumor of the spine

A

hemangioma

95
Q

75% of hemangiomas occur where

A

spine and skull

96
Q

do hemangiomas produce symptoms

A

not usually

slow growing, may be slight pain - MOST symptomatic in T spine

if symptomatic, results from cord compression

97
Q

mandible and maxillary hemangioma can cause what

A

death by tooth extraction

98
Q

can you see hemangiomas on plain film

A

not usually

99
Q

what is the most common type of hemangioma

capillary or cavernous

A

cavernous

100
Q

what is the treatment for hemangiomas

A

curettage, packing, cryotherapy

101
Q

solitary osteochondromas are found in what location

A

MC in the knee

metaphysis

long tubular bones - femur, humerus, scapula, any bone preformed in cartilage

102
Q

what does solitary osteochondroma look like on imaging

A

hyaline lined cartilaginous cap - calcified

sessile (looks like a hill- broad proximally and narrow distally) and peducnulated (cauliflower stalk - narrow proximally and broad distally)

points away from joint because of muscle pull

cortex and medulla cavity blend with host bone

coat hanger exostosis

large lesions exhibit cauliflower exostosis

103
Q

75% of solitary osteochondromas occur in what age group

A

< 20

104
Q

what is the most common benign skeletal bone tumor

A

osteochondroma

105
Q

what tumor makes up 50% of all neoplasm in bone

A

osteochondroma

106
Q

which tumor contains a stalk and a cap

what part goes malignant

how do you know if its transforming into malignancy

A

osteochondroma

cap

cap > 2cm in adults and 3 cm in children indicate transformation

break in cortex of growing soft tissue mass = malignancy

107
Q

what imaging do you use to assess an malignant transformation of osteochondroma

A

MRI - to view cap thickness

108
Q

how do you treat osteochondroma

A

surgical excision if symptomatic

109
Q

what tumor occurs bilaterally and symmetrically with 2-100’s of tumors

A

hereditary multiple exostosis

110
Q

what is the average number of tumors seen in hereditary multiple exostosis

what kind of tumors are these

A

2-100s

average 10

osteochondromas

111
Q

what are some deformities and features of hereditary multiple exostosis

A

bayonet hand deformity - short ulna, outward bowing of radius, radioulnar joint subluxation

cauliflower pelvic lesions

112
Q

in what age does hereditary multiple exostosis occur

A

2-10

113
Q

what are the symptoms of hereditary multiple exostosis

A

painless lumpy joints

cauliflower pelvic lesions compress cord and may turn malignant

114
Q

osteomas are usually what asymptomatic but are a __ complaint

A

cosmetic

115
Q

what is gardeners syndrome considered (osteomas)

A

pre malignant

116
Q

what is the most common benign tumor of the hand

A

solitary enchondroma

117
Q

what does a solitary enchondroma metastisize into

A

chondrosarcoma

118
Q

enchondromas are painless but if they become large enough it may cause what

A

deformities of the hand

119
Q

where is olliers and maffuccis syndrome most commonly found

A

hands

120
Q

maffucci syndrome patients may have a positive __

A

ulnar variance - leads to TFCC damage

121
Q

what is a fibrous cortical defect also called

what is a non ossifying fibroma also called

A

fibrous xanthoma of bone

fibrous xanthoma of bone

122
Q

what is the size of a non ossifying fibroma

A

2-7 cm

123
Q

what is another term for simple bone cyst

A

unicameral bone cyst

124
Q

what tumor points away from the joint due to muscle pull

A

solitary osteochondroma

125
Q

what are ddx for enostomas

A

osteoid osteoma
blastic mets
osteopoikilosis

126
Q

why do osteoid osteomas respond to NSAIDS or aspirin

A

have analgesic and antipyretic effect on prostaglandins

127
Q

what is best treatment for osteoid osteoma

A

thermoregulation

128
Q

benign flocculated appearance, well defined, expansile, proximal humerus

A

enchondroma

129
Q

eccentric, lytic, well circumscribed, benign, hazy matrix in distal femur

A

fibrous cortical defect

130
Q

what soft tissue component in high amount indicates a hemangioma is unlikely to be symptomatic

A

fat

131
Q

what is the most common benign skeletal tumor

what is the most common benign spine tumor

A

skeletal - osteochondroma

spine - hemangioma

132
Q

the closer hereditary mutiple exostosis lesions are to the spine or axial skeleton indicates what

A

more likely to become malignant

133
Q

what procedure is used to determine a M spike

A

protein electrophoresis

134
Q

should benign tumors be irradiated

A

no

135
Q

its more likely to be malignant if ___

A

hot on bone scan

136
Q

what are features of malignant transformation

A

enlarging radiolucent area

fracture

disappearance of pre-existing calcification***

rapid growth of lesion

137
Q

what is helpful to detect malignant degeneration of multiple enchondromatosis

A

MRI

138
Q

when a patient has pain, what should be considered with multiple enchondromatosis even if abscence of radiographic findings

A

malignant transformation

139
Q

what are metabolically active and may grow throughout the patients life

A

enchondromas

140
Q

what kind of hemangiomas are present in maffuccis syndrome

what do they look like on xray

A

cavernous hemangiomas

opaque spots

141
Q

hemangiomas of maffuccis syndrome can occur where

A

other organs

such as GI tract

142
Q

how often do simple bone cysts udnergo pathological fracture

A

2/3 undergo pathological fracture

143
Q

calcaneal cyst is typically located where

what is the differential diagnosis

A

simple bone cyst at the base of the calcaneal neck

lipoma
pseudotumor - thinning of trabeculae

144
Q

aneurysmal bone cyst maybe caused by what

A

post trauma

145
Q

what is the mc benign tumor of the clavicle

A

ABC

146
Q

which tumor has a high recurrence rate

A

ABC

147
Q

what should you do with an intraosseous lipoma thats asymptomatic

A

leave it alone

148
Q

dystrophic calcification seen in intraosseous lipoma is known as what

A

cockade sign

pathognomonic appearance and location of lesion

149
Q

symptoms from hemangiomas are usually from what

what are the symptoms like

symptoms usually arise from what part of the spine

A

spinal cord compression

local pain and muscle spasm - radic, spinal steonosis, hyper/hypoesthesia

mid thoracic spine - spinal canal vs cord size is smallest

150
Q

how do you treat hemangiomas in the skull

A

spinal stenosis present and cord compression - decompression surgery

symptomatic skull lesions - en bloc excision

inoperable spinal lesion - radiation

151
Q

corduroy clothe appearance results in vertebral body being ___ than neighboring vertebral bodies

A

stronger

152
Q

do you have to restrict activities due to vertebral hemangiomas

A

do not restrict activities

153
Q

what does hemangioma look like on CT and MRI

A

CT - polka dot spine

MRI - jailhouse and corduroy cloth appearance

154
Q

fat vs blood hemangiomas

what imaging do you see these findings

A

fat - reduced likelihood of symptoms - T1

blood - increased likelihood of neural compression - T2 - associated with vertebral collapse

155
Q

osteochondromas produce pain when

A

when it invades nerves and blood vessels

156
Q

when do osteochondromas stop growing

A

after closure of growth plate

157
Q

large osteochondromas exhibit what

A

cauliflower exostosis