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AU'18 Oral Path II > Bone Neoplasms - part II > Flashcards

Bone Neoplasms - part II Flashcards

1
Q

malignant neoplasms of bone

A
  1. chondrosarcoma
  2. osteosarcoma
  3. metastatic disease
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2
Q

chondrosarcoma

A

malignancy of cartilaginous differentiation

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3
Q

T/F: chondrosarcoma is common

A

false, rare

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4
Q

what is the 2nd most common PRIMARY bone malignancy?

A

chondrosarcoma

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5
Q

who is affected by chondrosarcoma?

A

mostly adult males, 4th-6th decade

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6
Q

where does chondrosarcoma most commonly affect?

A
  1. femur
  2. pelvis
  3. ribs
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7
Q

T/F: teeth involved with chondrosarcoma test nonvital

A

false, VITAL

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8
Q

in what way might chondrosarcoma mimic dental infection?

A
  1. ± pain
  2. swelling
  3. loose teeth
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9
Q

radiographic features of chondrosarcoma

A
  1. poorly defined radiolucency with variable amounts of radiopacity
  2. may see widened PDL in area of tumor
  3. loss of lamina dura
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10
Q

T/F: larger chondrosarcoma lesions may appear unilocular

A

false, multilocular

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11
Q

histopathologic features of chondrosarcoma

A

invasive lobules of atypical cells showing cartilaginous differentiation

  1. hypercellular
  2. binucleation variation size/shape
  3. mitoses
  4. eggshell like chamber with vacuolar space holding chondrocyte
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12
Q

tx for chondrosarcoma

A

radical surgery “one chance for cure”

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13
Q

prognosis of chondrosarcoma depends on what?

A
  1. location

2. histopathologic grade of tumor

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14
Q

prognosis of chondrosarcoma

A

poor

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15
Q

death from chondrosarcoma is usually by what?

A

direct extension of tumor involving vital structures

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16
Q

where does chondrosarcoma often metastasize?

A

lung

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17
Q

T/F: osteosarcoma is uncommon

A

true

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18
Q

what is the most common PRIMARY bone malignancy?

A

osteosarcoma

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19
Q

skeletal distribution of osteosarcoma

A
  1. 8% jaws
  2. 10% humerus
  3. 15% hips/proximal femur
  4. 60% distal femur/knees
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20
Q

T/F: pain is often initial complaint in long bones and jaws in osteosarcoma pts

A

true

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21
Q

clinical features of osteosarcoma in jaws

A
  1. swelling
  2. loose teeth
  3. paresthesia
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22
Q

radiographic features of osteosarcoma

A
  1. mixed radiolucent/radiopaque with ill-defined borders

2. symmetrically widened PDL of teeth in area

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23
Q

what is an uncommon radiographic feature of osteosarcoma in the jaws?

A

“sun-burst” pattern

24
Q

which long bones are commonly affected by osteosarcoma?

A

around the knees

25
Q

T/F: teeth where osteosarcoma tumor is is NONVITAL

A

false, vital

26
Q

T/F: parosteal osteosarcoma has a better prognosis

A

true, b/c it’s peripheral

27
Q

what does parosteal osteosarcoma resemble clinically?

A
  1. peripheral giant cell granuloma

2. pyogenic granuloma

28
Q

what does osteosarcoma resemble radiographically?

A

focal COD

29
Q

how does the apex of the root with a osteosarcoma tumor appear radiographically?

A

has a spiked appearance

30
Q

histopathologic features of osteosarcoma

A
  1. infiltrating sheets of malignant spindle cells
  2. production of osteoid by tumor cells
  3. mitotic activity variable
  4. osteoblastic, chondroblastic and fibroblastic differentiation can be seen
31
Q

tx of osteosarcoma

A

historically was radical surgery only but recently…

  1. induction chemotherapy
  2. surgery to remove tumor
32
Q

T/F: prognosis for osteosarcoma in the jaws is better

A

true

33
Q

prognosis of osteosarcoma

A

fair

34
Q

where does osteosarcoma usually metastasize?

A

lung

35
Q

death due to osteosarcoma is due to what?

A

uncontrolled disease

36
Q

overall, metastases typically goes where?

A

to bone

37
Q

the most common form of cancer involving bone?

A

metastatic disease

38
Q

what is the 2nd most common form of cancer involving bone?

A

multiple myeloma

39
Q

T/F: metastatic disease occasionally affects the jaw

A

true

40
Q

T/F: metastatic disease can affect oral soft tissues as well

A

true

41
Q

metastasis due to metastatic disease below the neck may affect jaws via what?

A

Batson’s paravertebral plexus of veins

42
Q

Batson’s plexus

A

a VALVELESS vertebral venous plexus

43
Q

what may a Batson’s plexus allow?

A
  1. retrograde spread of tumor cells

2. bypassing filtration through the lungs

44
Q

Batson’s vertebral plexus connects what?

A

deep pelvic veins and thoracic veins in the internal vertebral venous plexuses

45
Q

T/F: over half of pts affect by metastatic disease is greater than 50 y.o.

A

true

46
Q

where does metastatic disease commonly affect?

A

mandible > maxilla > soft tissue

47
Q

what soft tissues does metastatic disease most commonly affect?

A

gingiva > tongue

48
Q

clinical features of metastatic disease

A
  1. paresthesia
  2. tooth mobility
  3. swelling
  4. hemorrhage
  5. pathologic fracture
  6. trismus
49
Q

what should you consider when a tooth socket doesn’t heal?

A
  1. granulation tissue
  2. lymphoma
  3. metastatic disease
50
Q

radiographic features of metastatic disease

A
  1. poorly defined radiolucency
  2. less commonly, radiopacity
  3. “moth eaten”
51
Q

histopathologic features of metastatic disease

A

“seeded effect” from scattered clusters of cells

52
Q

metastatic disease has the same pattern histopathologically as what?

A

primary malignancy

53
Q

what is metastatic disease most common?

A
  1. breast
  2. lung
  3. colon
  4. thyroid
  5. prostate
  6. kidney
  7. melanoma
54
Q

tx of metastatic disease

A
  1. palliation

2. radiation therapy

55
Q

prognosis of metastatic disease

A

very poor

56
Q

T/F: most patients with metastatic disease die within one year of the dx

A

true

AU'18 Oral Path II (31 decks)

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