Bone-Forming Tumors Flashcards
What patients will get Osteoid Osteomas?
Young men
Describe the symptoms of Osteoid Osteomas
Pain that is WORSE AT NIGHT
What can differentiate Osteoid Osteomas from Osteoblastomas besides size?
Osteoid Osteomas respond to Aspirin and NSAIDS
– Osteoblastomas do NOT
What size are Osteoid Osteomas?
Less than 2 cm
Where are Osteoid Osteomas located?
Femur or tibia
How do Osteoid Osteomas look?
Central nidus of woven bone surrounded by osteoblasts
A central nidus of woven bone surrounded by osteoblasts on the femur or tibia is likely?
Osteoid Osteoma
Is there a bone reaction with Osteoid Osteomas?
Yes, thick rind of reactive cortical bone
What size are Osteoblastomas?
Greater than 2 cm
Where are Osteoblastomas usually located?
Posterior spine
Describe the pain with Osteoblastomas
Achey pain
Do Osteoblastomas respond to Aspirin/NSAIDs?
NO
– Osteoid Osteomas do
Is there a bony reaction with Osteoblastomas?
NO
What is the most common primary malignant bone tumor?
Osteosarcoma
Malignant mesenchymal cells produce bone matrix
Osteosarcoma
Describe the pain/location for Osteosarcomas
Painful enlarging mass at the KNEE
A painful enlarging mass presents at the knee
Osteosarcoma
Osteosarcomas have bimodal presenting ages. What are they?
- Less than 20 yo males
2. Older males with pagets or prior radiation
If an older male presents with an Osteosarcoma, what is likely in his history?
Pagets or PRIOR RADIATION
What is an aggressive x-ray sign of an Osteosarcoma?
Codman Triangle
What is the Codman Triangle and what is it seen with?
- Seen with Osteosarcomas
= Elevation of periosteum when bone breaks through the cortex
Patients with Osteosarcomas usually have acquired genetic abnormalities of tumor suppressor genes. What are the most common mutations?
RB gene!!
– Also TP53 –> Li-Fraumeni Syndrome
What is the histological description of Osteosarcomas?
Bizarre giant tumor cells including abnormal tri-polar forms
– lace like!
What is the histological description of Osteosarcomas?
Bizarre giant tumor cells including abnormal tri-polar forms
– lace like!
Osteosarcomas will spread through the medullary canal and replace the marrow while destroying the cortex. Where else can they spread?
Soft tissue spread
If an Osteosarcoma produces cartilage it is called?
Chondroblastic Osteosarcoma
What are all patients assumed to have at the time of diagnosis of an Osteosarcoma?
Occult malignancies
What gene is usually mutated with Osteosarcomas?
RB gene
Where are Osteosarcomas usually located?
Knee
