benign Tumors Flashcards
Commonest true benign tumor of bone
Osteoid osteoma
Commonest benign tumor of bone
Osteochondroma
Therapeutic test
Nagging pain worst at night which decreases on giving NSAIDS
- in osteoid osteoma
Osteoid osteoma has
Nidus of tangled arrays of partially mineralized osteoid trabecular surrounded by dense sclerotic bone
Location of osteoid osteoma
Diaphysis
- long bones: tibia, femur
Age group affected by osteoid osteoma
10-25 years( young adults)
Investigation in osteoid osteoma
- X-ray: typical radiolucent nidus (<1 cm diameter) surrounded by zone of dense sclerotic bone tumor
- CT SCAN: confirms diagnosis
T/t of osteoid osteoma
- complete excision of nidus along with sclerotic bone
- destroyed by CT localized radio frequency ablation
Enneking staging for benign tumor
- Latent lesion
- Active lesion
- Aggressive lesion
features of Latent lesion
- intracapsular
- grows slowly and stops
- well defined margin
- no cortical destruction
- no t/t required
Eg: osteoid osteoma
Features of active lesion
-intracapsular
- actively growing
- well defined margin
- May expand and thin the cortex
- extended curettage is the t/t
Eg: aneurysmal bone cyst
Features of aggressive lesion
-extracapsular
- tendency to recur
- break through the reactive bone possibly the cortex
- extended curettage and marginal/wide resection is t/t
Eg: symptomatic giant cell tumor
Osteochondroma has
-bony stalk with a cartilaginous cap
Why osteochondroma is not a true neoplasm?
- as its growth stops with cessation of growth at epiphyseal plate
Location of osteochondroma
Metaphyseal area of any bone developing by endochondral ossification
- distal femur, proximal tibia, proximal humerus, distal radius, distal tibia
Can also occur in flat bones of pelvis
Trevor’s disease
Osteochondroma on epiphyseal side of growth plate
Classical feature of osteochondroma
- cortex and cancellous bone of osteochondroma are continuous with the cortex and cancellous bone of host
Feature suggestive of malignant transformation of osteochondroma
Further enlargement after the end of growth plate
Age group for osteochondroma
<20 years of age ( during growth period)
Symptoms of osteochondroma
- Painless swelling
- pain once complications like bursitis, malignat change has begun
Signs of osteochondroma
- firm, non- tender, palpable swelling fixed to bone around joints
- tenderness and warmth if bursa inflamed
- restricted joint movements
- abnormal cosmetic appearance
- interference of tendon function, growth disturbance
Causes of sudden pain in osteochondroma
- fracture
- sarcomatous change
- bursitis of overlying bursa
- impingement of neighboring structures: nerves, vessels
Radiological findings in osteochondroma
- mushroom shaped outgrowth of bone at metaphysis either sessile or pedunculated, 2-12 cm in size
- tumor showing cortical and medullary portion continuous with the host bone
- tumor looks smaller than it feels because cartilage cap is not seen on X-ray unless calcified
T/t of osteochondroma
- not required unless complications develop
- complete excision including periosteum over the exostosis is done
- excision of osteochondroma should, if possible be postponed until later adolescence due to risk of recurrence and growth arrest
Other name of osteochondroma
Exostosis
Multiple hereditary exostosis also known as:
- diaphysialaclasia
MHE is:
Autosomal dominant disorder where there is failure of bone remodeling and this excess of metaphyseal growth is not resorbed forming multiple irregular cartilage capped exostosis
Radiological feature of MHE
- classical trumpet shaped metaphysis and bony projections from it
- deformities like bowing of radius, genu valgum, ankle valgum
Benign tumor of hyaline cartilage is:
Chondroma
Chondroma arising from medullary cavity is:
- asenchondroma
Chondroma arising from surface of bone is k/a
Subperiosteal or juxta-cortical chondroma
Location of enchondroma
Tubular bones of hand and feet
Enchondroma is:
Benign tumor consisting of lobulated mass of cartilage encapsulated by fibrous tissue
Types of enchondroma
- Ollier’s disease (chondrodysplasia)
2. Maffuccis’s syndrome
