Bone and Cartilage Tumors Flashcards
What bone conditions might show lesions in the brain?
Paget’s disease or osteoma
What benign bone neoplasms can present on the epiphysis of a bone?
Chondroblastoma or giant cell tumors
What benign bone neoplasms can present on the metaphysis of long bones?
- osteoblastoma
- osteochondroma
- Non-ossifying fibroma
- osteoid osteoma
- Chondromyxoid fibroma
- Giant cell tumor
What benign bone neoplasms can present on the diaphysis of long bones?
Enchondroma or Fibrous dysplasia
What malignant bone neoplasma can present on the diaphysis of long bone?
Ewing’s sarcoma or Chondrosarcoma
What malignant bone neoplasma can present on the metaphysis of long bones?
Osteosarcoma or Juxtacortical osteosarcoma
What are the most common primary bone neoplasms?
- MM
- osteosarcoma
- chondrocytomas
- Ewing’s sarcoma
Note that by far most bone tumors are metastatic carcinomas
Age rule with bone neoplasms
under 30= benign, over= malignant usually
Metastasis of bone neoplasms is usally via ____
venous circulation
Patient population for osteoma?
Adults and children (male slightly more than female)
Describe osteomas
bone formaing tumors composed of compact or mature trabecular bone that are confined almsot exclusively to cranial-facial bones (paranasal sinuses) and present with pain, headache, and vision changes
Osteomas are associated with what?
Gardner syndrome
What is Gardner syndrome?
a variant of familial adenomatous polyposis caused by APC gene mutations on chromosome 5q21
MOI of Gardner syndrome?
AD
What is gardner syndrome characterized by primarily?
multiple colon polyps
Where else can extracolonic tumors present in Gardner syndrome?
- osteomas in the skull
- thyroid cancers
- epidermoid cysts
- fibromas
- desmoid tumors in approx. 15% of patient s
What case the epidermoid cysts seen in Gardner syndrome?
doubling of the squamous layer of skin with keratin debris in middle
Describe osteoid osteomas
benign tumors of young (less than 25) males associated with osteoblasts that produce osteoid surrounded by a rim of reactive bone (common in cortex of long bones of the leg)
less than 1.5cm in diameter
How does osteoid osteoma present?
(may be nocturnal) bone pain in the leg of a young male that resolves with aspirin
How are osteoid osteomas treated?
radiofrequency ablation
Describe osteoblastomas.
similiar to an osteoid osteoma but is LARGER (2+ cm), and is associated with dull bone pain but IS NOT relieved by aspirin
How else are osteoblastomas differentiated from osteoid osteomas?
more commonly found in the VERTEBRAE, in female and children, and NOT relieved by aspirin
How are osteoblastomas treated?
curettage or excision
What bone neoplasm is characterized by a MALIGNANT proliferation of osteoblasts?
osteocarcomas
What patient population is common for osteosarcomas?
60% male, ages 10-20
Associations with osteocarcomas?
Paget disease and post-radiation in older patients
as well as Rb gene (retinoblastoma)= poor prognosis
Microscopic presentation of osteocarcoma?
spindle cell appearance with unmineralized/osteoid bone
How common is metastasis with osteocarcoma?
20% will have lung METs at diagnosis
Common spots for osteosarcoma?
- knee metaphysis (60%)
- hip (15%)
- shoulder (10%)
- nasal (8%)
Buzzword on xray with osterosarcoma?
Codman Triangle- periosteal reaction (indicates an aggressive tumor)
Buzzoword on bone biopsy with osteosarcoma?
‘lace like’