Bone Pathology II: Bone Neoplasms

Question 1

Are primary bone neoplasms rare?

Answer 1

YES

Question 2

Osteoma

Answer 2

Benign tumor like mass of abnormally dense bone

Question 3

Where are osteomas commonly found?

Answer 3

Skull

Question 4

What age do osteomas typically appear?

Answer 4

4th to 5th decade

Question 5

• Osteomas
• Epidermal cysts
• Fibromatoses
• Colonic adenomatous polyposis

Answer 5

Gardner’s Syndrome

Question 6

Osteoid Osteoma

Answer 6

Benign highly vascular and well-circumscribed osteoblastic proliferation that is almost always singular

Question 7

Where are osteoid osteomas typically found?

Answer 7

Long bones

Question 8

What is the characteristic appearance of osteoid osteoma on x-ray?

Answer 8

Targetoid Appearance

Question 9

Osteosarcoma

Answer 9

High grade sarcoma most often seen younger patients and presents as a painful tender mass

Question 10

What is the most common location of osteosarcoma?

Answer 10

Knee

Question 11

Codman Triangle

Answer 11

Triangular shadow between the cortex and raised ends of periosteum as the tumor has broken through the cortex and lifted the periosteum

Question 12

Osteochondroma

Answer 12

Outgrowth of medullary and cortical bone covered with a cartilaginous cap that is more of a malformation than a neoplasm

Question 13

Osteochromatosis

Answer 13

Multiple hereditary osteochondromas

Question 14

Chondrosarcoma

Answer 14

Malignant cartilage forming tumor

Question 15

What gender is more affected by chrondrosarcoma?

Answer 15

Males

Question 16

Ewing’s Sarcoma

Answer 16

Primary osseous neoplasm of small and round mesenchymal cells which are rich in cytoplasmic glycogen

Question 17

What is the chromosome tranlocation seen in Ewing’s sarcoma?

Answer 17

Ch11:Ch22 translocation

Question 18

What is the result of the t(11;22) translocation in Ewing’s sarcoma?

Answer 18

EWS/FLI-1 gene fusion which over expresses MIC2

Question 19

Fibrous Dysplasia

Answer 19

Benign intramedullary proliferaton of fibrous and bone tissue

Question 20

What is the radiographic appearance of fibrous dysplasia?

Answer 20

Ground Glass

Question 21

• Polyostotic fibrous dysplasia
• Precocious pubert
• Unilateral macular pigmented skin lesions
• Fibromyxomatous soft tissue tumor
• Recurrent fractures

Answer 21

McCune-Albright’s Syndrome

Question 22

What mutation is McCune-Albright’s Syndrome associated with?

Answer 22

GNAS-1 mutation

Question 23

Giant Cell Tumor of Bone

Answer 23

Locally aggressive bone neoplasm with large number of osteoclast-like giant cells with mononuclear cells in background

Question 24

What are common metastases to the bone?

Answer 24

• Prostate
• Breast
• Kidney
• Lung

Question 25

What are common metastases in children to the bone?

Answer 25

• Neuroblastoma
• Wilm’s tumor
• Rhabdomyosarcoma