bone neoplasms Flashcards

1
Q

What is an osteoma? Where do they arise With what are they associated?

A

benign tumor of the bone that usually arises on the surface of the facial bone. associated with gardner’s syndrome (familial adenomatous polyposis plus fibromatosis in the retroperitonium. fibromatosis is a non-neoplastic prolif of fibroblasts that grows and destroys local structure)

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2
Q

What is an osteoid osteoma? Who gets these? Where do they arise?

A

benign tumor of osteoblasts (osteoid) surrounded by a rim of reactive bone (osteoma). seen in young adults under 25, esp. young men. arise in the cortex of long bones, esp. the diaphysis (long shaft of bone)

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3
Q

Presentation of osteoid osteoma. imaging?

A

bone pain that resolves with aspirin. imaging shows a bony mass with a radiolucent core (this is osteoid)

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4
Q

What is an osteoblastoma?

A

similar to osteoid osteoma, but arises in vertebrae, is greater than 2 cm, and presents as bone pain that doesn’t respond to aspirin

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5
Q

What is osteochondroma? Where does it arise? Complications?

A

tumor of bone with overlying cartilage cap. most common benign tumor of bone, seen in males under 25. arises from a lateral projection of the growth plate. bone is continuous with the marrow space. can transform to a chondrosarcoma (rare)

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6
Q

What is an osteosarcoma? Who gets it?

A

malignant proliferation of osteoblasts. peak incidence in teens, second (less common) peak in elderly >65.

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7
Q

risk factors for osteosarcoma

A

familial retinoblastoma (incr. risk of bilateral retinoblastoma and osteosarcoma), Paget disease, radiation, Li-Fraumeni, bone infarcts

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8
Q

Where do osteosarcomas arise? presentation?

A

metaphysis of long bones, usually distal femur or proximal tibia (knee region). presents as a pathologic fracture or bone pain with swelling.

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9
Q

What does the imaging show in an osteosarcoma? Biopsy?

A

destructive mass with a sunburst appearance and lifting of the periosteum off the bone. creates an angle called “codman’s angle”
biopsy shows pleomorphic cells that produce osteoid
treat with en bloc resection and chemo

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10
Q

What is a giant cell tumor? Who gets it? Where

A

tumor of multinucleated giant cells and stromal cells seen in young adults (20-40). arises in the epiphysis of long bones, esp. distal femur or proximal tibia.

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11
Q

clinical features of giant cell tumor and appearance of x ray

A

soap bubble appearance (reactive bone formation circling the tumor). locally aggressive and may recur

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12
Q

What is a ewing sarcoma? Who gets it, and where?

A

maliogant proliferation of poorly differentiated cells from the NEUROECTODERM. arises in the diaphysis of long bones, usually in male kids.

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13
Q

Ewing sarcoma: x ra appearance, biopsy, clinical course, translocation

A

onion skin onx-ray, small round blue cells that resemble lymphocytes on biopsy (may be confused with lymphoma. 11,22 translocation is characteristic. often appears with mets but is responsive to chemo

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14
Q

What is a chondroma? Where does it arise?

A

benign tumor of cartilage that arises in the medulla of small bones of hands and feet.

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15
Q

What is a chondrosarcoma? Where does it arise?

A

malignant cartilage forming tumor that arises in the medulla of the pelvis or central skeleton (or humerus, tibia, femur)

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16
Q

What is a typical metastaic tumor to bone? How does it present?

A

more common than primary tumors. usually result in osteolytic lesions. However, prostate cancer classically produces osteoblastic lesions.

17
Q

What is osteitis fibrosa cystica

A

brown tumors d/t fibrous replacement of bone with subperiosteal thickening

18
Q

what is osteitis fibrosa cystica from primary hyperparathyroidism? lab findings/

A

idiopathic or parathyroid hyperplasia, adenoma, or carcinoma.
incr. serum Ca, decr. phosphate, incr. ALP, incr. PTH

19
Q

lab findings for osteitis fibrosa cystica from secondary hyperparathyroidism? causes?

A

compensation for ESRD (decr. phosphate exretion and production of activated vitamin D). decr. Ca, increased PO4 3-, incr. Alk phos, incr. PTH.