Bone tumors Flashcards
How would this lesion look on histology?
Whorled, irregular bone resembling Chinese characters
(Large, expansile medullary mass with adjacent moth-eaten appearance on Xray = FIBROUS DYSPLASIA)
This X ray would most likely be seen in what demographic? Complication?
Male child/adolescent - fracture due to thin bone margins
(Solitary bone cyst - fluid filled and in femur)
What would you expect this lesion to look like on histology?
Storiform pattern = woven mat
(Nonossifying fibroma = fibrous cortical defect > 5-6cm)
What test should you run on this patient to confirm your diagnosis?
PPD, CXR
(Giant cells in bone = TB or giant cell tumor)
Dx?
Aneurysmal bone cyst
(Notice all the blood)
2 complications of this finding
Bleeding
Fracture
(Aneurysmal bone cyst - dilated, fluid-filled mass in a long bone)
What other two conditions may be present in this patient with a genetic condition?
FAP + osteoma
(this is a retroperitoneal fibroma = Garnder’s syndrome if other 2 present)
This pt may be at increased risk for:
Chondrosarcome
(This is an osteochondroma - notice stalk growing out from metaphysis)
15 yo soccer player complaining of bone pain in the knee area. Dx?
Osteosarcoma
(Presence of osteoid + pleomorphic cells + age group)
22 yo male complaining of severe hip pain. How would you treat this lesion?
ASA
(Osteoid osteoma - produces PGE2)
Cross section of bone from which this biopsy was taken would reveal:
Onion skinning (layers of reactive periosteum and neoplasm)
(This shows Homer-Wright rosettes classic of Ewing’s sarcoma)
This tumor may have formed from a preexisting:
Enchondroma
(This is a chondrosarcoma - the cartilage cap of an enchondroma may develop into a chondrosarcoma)
A biopsy of a bone mass in a kid with premature puberty and several large “birthmarks” reveals this finding. Dx?
McCune-Albright syndrome
(Whorled, irregular bone resembling chinese characters = fibrous dysplasia; + endocrinopathy + cafe-au-lait skin pigmentation = McCune-Albright)
Dx?
Enchondroma
(Single cartilage mass in long bone of hand)
If this lesion was noted on Xray of a kid complaining of pain in the knee area… Dx?
Benign fibrous histiocytoma
(Fibrous cortical defect [scooped out appearance of proximal tib] forming a mass + involving medulla)
Demographic of this pt?
20-40 yo
(Soap bubble appearance in wrist or knee = giant cell tumor; notice how it’s coming from the EPIPHYSIS)
In addition to the skin and orthopedic findings, this child may also have what other problem?
Endrocrinopathy
(Cafe au lait pigmentation + polyostotic fibrous dysplasia = McCune Albright Syndrome)
If this finding was present at autopsy of a 75 year old woman, what two things might you look for in her history?
Paget’s disease, radiation exposure
(Osteosarcoma)
Dx?
Maffucci syndrome
(Hemangiomas + enchondromas)
Two other findings to check for?
Osteoma + retroperitoneal fibroma (desmoid tumor)
(FAP + other 2 = Gardner’s syndrome)
Demographic?
White kids < 15 yo
How would you treat this lesion?
Surgery
(Osteosarcoma - insensitive to chemo)
Which cancer could cause this finding if it metastasized to bone?
Prostate
(Osteoblastic metastases)
How did this lesion develop?
Lateral displacement of growth plate with a cartilage cap drug out over it
(Osteochondroma - notice stalk)
X ray findings if this cancer metastasized?
Punched out lesions
(Multiple myeloma = osteolytic)
How would a patient with this histological finding present?
35-60 yo with pain in the axial skeleton; may have Phx of enchondroma
(Chondrosarcoma - pleomorphic cells resembling chondrocytes)
Dx?
Chondroma
(Notice all the hyaline cartilage; doesn’t look too pleomorhpic = probably not a chondrosarcoma)
How would you treat this lesion?
Let it heal spontaneously
(Fibrous cortical defect = scooped out appearance of distal tib < 5-6 cm)
DDx?
Aneurysmal bone cyst
Renal metastasis
Dx?
Ollier disease
(Multiple enchondromas - notice position in medulla of long bones of the hand)
What causes this characteristic finding?
Periosteal elevation
(Codman’s triangle - osteosarcoma)
Confirmatory test?
Genetic testing for t11,22
(Ewing’s sarcoma = small round blue cells)
Dx?
Aneurysmal bone cyst
(Sponge filled with blood)
