Bone Diseases 4

Question 1

______ is the most common malignant neoplasm

located in bone

Answer 1

Metastatic carcinoma

Question 2

_______ is the most common malignant neoplasm

arising within bone

Answer 2

Multiple myeloma

Question 3

_______ is the most common malignant neoplasm arising

from bone

Answer 3

Osteosarcoma

Question 4

A malignant neoplasm in which either bone or osteoid
is directly produced by the malignant stroma
*may also produce:
Chondroid
- chondroblastic osteosarcoma
Collagen
- fibroblastic osteosarcoma

Answer 4

Osteosarcoma

Question 5

Most common site is long bones
around knee
Head & neck <10%

Answer 5

Osteosarcoma

Question 6

Signs and symptoms of \_\_\_\_\_\_:
Pain – earliest symptom
Swelling
Pain and Swelling - 50%
Frequent history of dental extraction

Answer 6

Osteosarcoma

Question 7

Radiographic appearance of \_\_\_\_\_\_\_\_:
Lytic or sclerotic
Ill-defined margins
Variable sunburst pattern - osteophytes
Variable localized symmetrical widening of 
periodontal ligament space (PDL)

Answer 7

Osteosarcoma

Question 8

Name the disease
associated with generalized
widening of the periodontal
ligament space.

Answer 8

Scleroderma

Question 9

TREATMENT AND PROGNOSIS 
OF \_\_\_\_\_\_\_\_
 Combination surgery and chemotherapy
 Neo-adjuvant (preoperative) chemotherapy
 Radical surgical resection
 Adjuvant (postoperative) chemotherapy
 3-Year survival rates
 1970 20%
 1985 65%

Answer 9

OSTEOSARCOMA

Question 10

_______ bone exhibits higher incidence

of benign and malignant neoplasms

Answer 10

Pagetic

Question 11

______ is the most common sarcoma

complicating Paget disease

Answer 11

Osteosarcoma

Question 12

Frequency related to radiation dose
Osteosarcoma most common type of post-irradiation sarcoma
 Fibrosarcoma, chondrosarcoma
Histologic features and prognosis identical for de novo tumors

Answer 12

POST-IRRADIATION BONE SARCOMA

Question 13

A malignant neoplasm in which cartilage is
directly produced by the malignant stroma.
Osteoid is not produced

Answer 13

Chonrosarcoma

Question 14

If bone is produced along with cartilage, how is the neoplasm named?

Answer 14

Osteosarcoma

Question 15

Is a chondrosarcoma more common in mand or max?

Answer 15

Max

Question 16

 Young people, 5 to 20 years
 Pain and swelling
 Constitutional symptoms - may mimic an inflammatory process
 Mimics infection with fever, leukocytosis, elevated ESR
 Pelvis and lower extremity are the most common sites; rare in
craniofacial bones

Answer 16

Ewing sarcoma

Question 17

85% of ES/PNET exhibit the chromosomal
translocation t(11;22)
Translocation can be detected by
Fluorescent In-Situ Hybridization (FISH)

Answer 17

Ewing sarcoma

Question 18

What is the chromosomal translocation seen in Ewing sarcoma?

Answer 18

T(11:22)

Question 19

Tx and prognosis of \_\_\_\_\_\_:
Systemic chemotherapy followed by local
therapy (surgery or radiation therapy)
50% five-year survival in the absence of 
metastasis

Answer 19

Ewing sarcoma

Question 20

Older adults
Disseminated neoplasm of terminally-differentiated B
lymphocytes (plasma cells)
Multifocal lytic bone lesions, hypercalcemia, bone
pain
Myelophthisic anemia, predisposition to infections

Answer 20

Multiple myeloma

Question 21

Oral findings in \_\_\_\_\_\_
Lytic lesions, 
Loose teeth, 
Pain, 
Paresthesia, 
Pathologic fracture
Macroglossia - amyloidosis

Answer 21

Multiple myeloma

Question 22

Laboratory findings in ______;
 Elevated serum calcium, protein, immunoglobulins
 Elevated erythrocyte sedimentation rate (ESR)
 Rouleaux formation
 Monoclonal gammopathy - M-spike
 Bence-Jones proteinuria -
immunoglobulin light chains

Answer 22

Multiple myeloma

Question 23

What are the 3 COMPLICATIONS OF

MULTIPLE MYELOMA?

Answer 23

Renal failure
Infection
Anemia