Bone and Soft Tissue Tumors Flashcards
What are the 18 and 2* ossification centers?
metaphysis and epiphysis
What are the 4 adult soft tissue sarcomas?
UPS/MFH
liposarcoma
leiomyosarcoma
angiosarcoma
What are the 3 soft tissue tumors of children? How do they metastasize?
rhabdomyosarcoma
synovial sarcoma
epithelioid sarcoma
How are benign soft tissue tumors characterized?
small, slow growing, well-circumscribed and homogenous surface
How are malignant soft tissue tumors classified?
large, hemorrhagic, necrotic, rapid growing, poorly cirumscribed, heterogenous surface
What are the prognostic factors for soft tissue tumors?
stage- most important
grade
size
location- superficial and peripheral are better than deep and central
What does the prognostic factor of grade indicate?
degree of differentiation
low-> high determined by amt of mitosis, cellularity, pleomorphism, necrosis
What is the histological appearance of low grade vs high grade fibrosarcoma?
low: elongated spindle cells, fat, pink collagen, limited mitosis and no necrosis
high: hypercellularity, mitotic figures, unorganized
What are the common routes of metastasis for soft tissue sarcoma?
lung via blood
lymphatics
What are the treatments for soft tissue sarcomas?
radiation
surgery
chemotherapy- only for some pediatric cases usually
What are the 3 most common soft tissue tumors?
MFH
liposarcoma
synovial sarcoma
What are some differential diagnoses for small round blue cell tumors in bone?
Ewings, osteosarcoma, lymphoma/leukemia, neuroblastoma, chondrosarcoma
What are some of the differential diagnosis for small round blue cell tumors of soft tissue?
Ewings, rhabdomyosarcoma, round cell liposarcoma, mesenchymal chondrosarcoma, synovial sarcoma
If you suspect a bone tumor in an adult, what is the generalization until proven otherwise?
MM or metastatic disease
What is the treatment for osteosarcoma?
pre-op chemo, surgery resection, post-op chemo
what is the treatment for Ewings?
chemo, possibly: surgery resection, radiation
What are the primary sites for skeletal metastases?
Osteoblastic? *
Osteolytic?
PTBLK- adults
prostate*, thyroid, breast, lung, kidney
children- neuroblastoma and wilms tumor
Which bones are commonly metastasized too first?
skull, vertebrae, pelvis
tubular bones are more rarely met to.
What are the clinical manifestations of bone mets?
pain, pathological fractures and marrow dysfunction
Giant cell tumors most commonly occur where, what ages and gender?
males/females, 30s, knee/wrist
Osteosarcoma is characterized by what?
malignant tumor of direct bone/osteiod formation by proliferating tumor cells
What is the radiographic presentation of osteosarcoma?
fluffy osteoid, codman’s triangle, and cortical destruction mass
How is chondrosarcoma characterised? Radiographic presentation?
men, 50s, knee/hip
popcorn/smoke ring appearance on xray
Bx: see cartilage on bone bx of adult (not nl)
What is the epidemiology of ewings sarcoma?
boys, 10-12 yrs, white, femur/hip, chromosomal abl of t(11;22)
What is the clinical differential diagnosis of bone tumor with potential Ewings?
Osteomyelitis v tumor-Ewings Sarcoma
What is the radiographical appearance of Ewing’s Sarcoma?
onion-skinning periosteal reaction, permeative destruction, diphyseal
soft tissue mass on CT and MRI
