Bone and soft tissue tumors

Question 1

Most common primary tumor of bone

Answer 1

Multiple myeloma

Question 2

Benign chondrogenic bone tumors

Answer 2

Osteochondroma
Chondroma
Chondroblastoma
Chondromyxoid fibroma

Question 3

Malignant chondrogenic tumor

Answer 3

Chondrosarcoma

Question 4

Benign osteogenic tumors

Answer 4

Osteoid osteoma
Osteoblastoma

Question 5

Malignant osteogenic tumor

Answer 5

Osteosarcoma

Question 6

Benign bone tumor of unknown origin

Answer 6

Giant cell tumor

Question 7

Malignant bone tumor of unknown origin

Answer 7

Ewing tumor

Question 8

Malignant notochord bone tumor

Answer 8

Chordoma

Question 9

Tumors of epiphysis

Answer 9

Chondroblastoma
Giant cell tumor

Question 10

Tumors of diaphysis

Answer 10

Enchondroma
Fibrous dysplasia
Ewing sarcoma
Chondrosarcoma

Question 11

Small bosselated benign tumor of the facial bones and skull that histologically resembles normal bone

Answer 11

Osteoma

Question 12

Gardener’s syndrome

Answer 12

Multiple osteomas

Question 13

Bone tumor characterized by pain during the night relieved by NSAIDs and is typically found on the metaphysis of the femur or tibia

Answer 13

Osteoid osteoma

Question 14

Cause of pain at night in osteoid osteoma

Answer 14

Prostaglandin E2 produced by proliferating osteoblast

Question 15

Composed of haphazardly interconnecting trabeculae of woven bone that are rimmed by prominent osteoblasts with the intertrabecular spaces filled by vascularized loose CT

Answer 15

Osteoid osteoma

Question 16

Radiograph shows round radiolucency with central mineralization surrounded by abundant reactive bone that has a massively thickened cortex

Answer 16

Osteoid osteoma

Question 17

Differences between osteoblastoma and osteoid osteoma

Answer 17

Osteoblastoma is larger, with duller pain not relieved by NSAID, and it involves the spine

Question 18

Treatment for both osteoid osteoma and osteoblastoma

Answer 18

Surgery

Question 19

Bone tumor associated with RB mutation and retinoblastoma

Answer 19

Osteosarcoma

Question 20

Malignant mesenchymal tumor where the neoplastic cells produce bone matrix, predominantly in those <20 yo

Answer 20

Osteosarcoma

Question 21

Secondary causes of osteosarcoma in elderly

Answer 21

Paget disease
Bone infarct
Prior radiotion

Question 22

Big, bulky, gritty, gray-white tumors of the metaphysis of long bones with areas of hemorrhage and cystic degeneration

Answer 22

Osteosarcoma

Question 23

Pleomorphic tumor cells with larger hyperchromatic nuclei, bizarre giant cells, and mitotic figure with fine and lacelike neoplasm of bone

Answer 23

Osteosarcoma

Question 24

Periosteal reactions in osteosarcoma

Answer 24

Sunburst appearance
Codman’s triangle

Question 25

Inheritance of multiple hereditary exostosis syndrome

Answer 25

Autosomal dominant

Question 26

Benign tumor that develops only in bone of endochondral origin

Answer 26

Osteochondroma/exostosis

Question 27

Attached to the skeleton by a bone stalk capped by benign hyaline cartilage covered by perichondrium on the metaphysis near the growth plate

Answer 27

Osteochondroma

Question 28

Histologic appearance of cartilage in osteochondroma

Answer 28

Disorganized growth plate that undergoes endochondral ossification

Question 29

Benign tumor of hyaline cartilage that occurs in bones of endochondral origin

Answer 29

Chondroma

Question 30

Mutation associated with chondroma

Answer 30

IDH mutation

Question 31

Location of enchondromas

Answer 31

In medullary cavity

Question 32

Location of juxtacortical chondromas

Answer 32

On bone surface

Question 33

Ollier syndrome

Answer 33

Nonhereditary condition associated with multiple enchondromas in the hands and feet. Pt c/o pain and fracture.

Question 34

Maffucci syndrome

Answer 34

Multiple enchondromas with soft tissue hemangiomas

Question 35

X-ray shows circumscribed lucency with central irregular calcifications, a sclerotic rim, and an intact cortex

Answer 35

Chondroma

Question 36

Composed of nodule of hyaline cartilage encased by a thin layer of reactive bone

Answer 36

Chondroma

Question 37

Malignant cartilage producing tumors, commonly in axial skeleton

Answer 37

Chondrosarcoma

Question 38

Large bulky tumors made of nodules of glistening gray-white translucent cavity that destroy bone that presents as a painful, progressively enlarging mass

Answer 38

Chondrosarcoma

Question 39

Characterized by the presence of numerous multinucleated osteoclast-type giant cells that is benign, but can be locally aggressive

Answer 39

Giant cell tumor or osteoclastoma

Question 40

Bone tumor of large, red-brown mass that may have cystic degeneration that occurs in the epiphysis, but may extend into the metaphysis

Answer 40

Giant cell tumor

Question 41

X-ray shows predominantly lytic and expansile with destruction of cortex

Answer 41

Soap bubble appearance of giant cell tumor

Question 42

Pathogenesis of giant cell tumor

Answer 42

Neoplastic cells are primitive osteoblast precursors expressing increased RANKL which promotes proliferation of osteoclasts

Question 43

Rare metastasis of giant cell tumor

Answer 43

Lung

Question 44

Treatment with good response for giant cell tumor

Answer 44

Denosumab --> RANKL inhibitor

Question 45

Malignant bone tumor characterized by primitive round cells without obvious differentiation

Answer 45

Ewing's sarcoma

Question 46

Pathogenesis of Ewing's sarcoma

Answer 46

t(11;22) creating an EWSR1/FLI1 fusion gene

Question 47

Soft, tan-white bone tumor mainly in medullary cavity with areas of hemorrhage and necrosis

Answer 47

Ewing's sarcoma

Question 48

Rounded cell clusters with a central fibrillary core and sheets of uniform, small, round cells with scant clear cytoplasm

Answer 48

Ewing's sarocma

Question 49

Homer-Wright rosette

Answer 49

Rounded cell clusters with a central fibrillary core that indicate neuroectodermal differentiation

Question 50

Bone tumor that presents as painful, enlarging mass that is warm to touch and tender with fever

Answer 50

Ewing's sarcoma

Question 51

X-ray shows destructive lytic tumor permeating into soft tissue with layers of reactive bone deposition

Answer 51

Ewing's sarcoma

Question 52

Cancers that can cause osteolytic metastasis to bone

Answer 52

Carcinomas of kidney, lung, and GIT

Question 53

Cancer that can cause osteoblastic metastasis to bone

Answer 53

Prostate CA

Question 54

Benign tumor where all the components of normal bone are present, but do not differentiate into mature structures

Answer 54

Fibrous dysplasia

Question 55

Mutation associated with fibrous dysplasia

Answer 55

Gain of function mutation in GNS1 that codes for alpha subunit of Gs

Question 56

Tan-white, well-circumscribed, expansive lesion with an intramedullary location

Answer 56

Fibrous dysplasia

Question 57

X-ray shows well-defined, radiolucent areas with thin-cortices and ground-glass appearance in the proximal midshaft

Answer 57

Fibrous dysplasia

Question 58

Curvilinear trabeculae of woven bone surrounded by a fibroblastic proliferation without prominent osteoblastic rimming

Answer 58

Fibrous dysplasia

Question 59

Mazabraud syndrome

Answer 59

Polyostotic fibrous dysplasia with soft tissue myxomas

Question 60

McCune-Albright syndrome

Answer 60

Polyostotic fibrous disease with Cafe-au-lait macules and precocious puberty

Question 61

Well-encapsulated, soft, yellow lesions often indistinguishable from normal adipose

Answer 61

Lipoma

Question 62

Malignant tumors of adipose tissue

Answer 62

Liposarcoma

Question 63

Characteristic cell of liposarcoma with central, scalloped nuclear and numerous fat vesicles

Answer 63

Lipoblast

Question 64

Benign neoplasm of skeletal muscle

Answer 64

Rhabdomyoma

Question 65

Associated with cardiac rhabdomyoma

Answer 65

Tuberous sclerosis

Question 66

Malignant mesenchymal tumor with skeletal muscle differentiation

Answer 66

Rhabdomyosarcoma

Question 67

Four types of rhabdomyosarcoma

Answer 67

Alveolar Embryonal Pleomorphic Spindle cell/sclerosing

Question 68

Rhabdomyoblasts

Answer 68

Differentiation strap cells with clearly visible cross-striations in embryonal rhabdomyosarcoma

Question 69

Sarcoma botryoides

Answer 69

Variant of rhabdomyosarcoma that develops in the walls of hollow, mucosa-lined structures

Question 70

Skeletal muscle specific markers commonly expressed by rhabdomyosarcoma

Answer 70

Myogenin MyoD1