Bone Tumors Flashcards by Angela Newland

Q

MC Benign Bone Tumor of the Appendicular Skeleton Either pedunculated or sessile

A

Osteochondroma

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Q

Multiple osteochondromas 20% undergo malignancy

A

Hereditary Multiple Exostosis (HME)

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Q

Diaphyseal/Metaphyseal location Centrally located < 20 yo Associated with “Fallen Fragment sign”

A

Unicameral Bone Cyst aka Simple Bone Cyst

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Q

Diaphyseal/metaphyseal location Eccentrically located < 20 ya

A

Aneurysmal Bone Cyst (ABC)

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Q

Epiphyseal/Metaphyseal location 20-40 yo 20% of the time quasi-malignant Associated with “Soap Bubble Appearance” (saponaceous)

A

Giant Cell Tumor (GCT)

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Q

Epiphyseal/Metaphyseal location < 20 yo

A

Chondroblastoma

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Q

Night Pain relieved by Aspirin Radiolucent central Nidus with severe reactive sclerosis

A

Osteoid Osteoma

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Q

Night Pain relieved by Aspirin Appears like an osteoid osteoma

A

Brodie’s Abscess aka Chronic Osteomyelitis

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Q

MC Benign Bone Tumor of the Hand May have a stippled appearance

A

Enchondroma

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Q

Multiple Enchondromas are called…

A

Ollier’s Disease

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Q

Ollier’s has what rate of malignant degeneration

A

10-50%

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Q

Enchondroma with soft tissue calcification is known as…

A

Maffucci’s Syndrome

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Q

MC Benign Bone Tumor of the Spine Will appear with vertical striations “Corduroy Cloth Appearance”

A

Hemangioma

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Q

Bone Island Round or oblong radiopaque lesion

A

Enostoma

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Q

Multiple Bone Islands

A

Osteopoikilosis

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Q

MC Benign Bone Tumor to affect the Neural Arch

A

Osteoblastoma

Q

MC Benign Bone Tumor to affect the Skull MC found in the Frontal Sinus Best seen on the Caldwell Projection

A

Osteoma

Q

Monostotic form (70%) associated with “Rind Sign” Polystotic form (30%) Physiological reabsorption of normal bone replaced by fibrous tissue

A

Fibrous Dysplasia

Q

Causes deformities such as “Saber Shin Tibia” & “Sheppard’s Crook” Has a “Ground Glass” appearance, “Cafe au lait” spots with the “Coast of Maine” appearance

A

Fibrous Dysplasia

Q

Familial history Pt may present with scoliosis, cervical kyphosis, VB scalloping with IVF enlargement, “cafe au lait” spots with the “Coast of California” appearance

A

Neurofibromatosis

Q

MC Primary Malignancy of Bone Malignant proliferation of plasma cells infiltrating bone marrow > 50 yo Cachexia, Weight Loss, Anemia

A

Multiple Myeloma

Q

Multiple dark densities that are similar in size “Punched out Lesions” Can cause pathological collapse (vertebral plana) Associated with “Rain Drop Skull”

A

Multiple Myeloma

Q

Labs to diagnose: 1) M-Spike on ImmunoElectroPhoresis 2) Reversal of Albumin/Globulin Ratio 3) Bence-Jones Proteinuria 4) Elevated ESR Special Test: Bone Scan, Cold

A

Multiple Myeloma

Q

MC Malignant tumor of Bone

A

Metastatic Disease (Lytic & Blastic)

Skeletal pain worse at Night Recent unexplained weight loss \> 40 yo - Trabeculae reabsorbed turns the bone darker in color - "Moth eaten" or permeative pattern of destruction - "Eats" away pedicle of bone - Has a "swiss cheese" appearance in the skull

Lytic Metastasis

What labs or special tests to diagnose Lytic Metastasis?

Labs: Alkaline Phophatase Special Test: Bone Scan

MC form of metastasis in ages 20-40 yo - Ivory White Vertebrae with anterior body scalloping - Unilateral hilar lymphdenopathy in male caucasians seen on PA chest view

Hodgkin's Disease

With Hodgkins disease, you need a biopsy to confirm what?

Reed Sternberg cells

Ivory White Vertebrae No Cortical thickening or bone enlargement \> 40 yo

Blastic Metastasis

What labs or special tests to diagnose Blastic Metastasis

Labs: Increased Alkaline Phophatase Special Test: Bone Scan

Males \> 50 yo - Cortical Thickening - Picture Frame Vertebrae - Increased Bone Density - Coarsened trabeculae - Bone Expansion - Bowing deformities

Paget's Disease aka Osteoitis Deformans

What are the 4 stages of Paget's disease?

1) Lytic or Destructive 2) Combined 3) Sclerotic 4) Malignant (osteosarcoma)

Labs or special tests to diagnose Paget's disease?

Labs: Increased Alk Phos & Urinary Hydroxyproline\*\*\* Special Tests: Bone Scan

MC malignancy found in children (10-30 yo) - Causes a periosteal reaction that is spiculated/radiating/sunburst in appearance

Osteosarcoma

Labs/special tests to diagnose osteosarcoma

Labs: Increased Alk Phos Special Test: Bone Scan

Creates a spiculated/radiating/sunburst appearance \> 40 yo

Chondrosarcoma & Fibrosarcoma

MC found in Diaphysis of Long Bones 10-25 yo +/- - Permeative lesion that causes a multi-paralleled "onion skin" type of periosteal reaction. - Bone expansion - Codman's triangle - Saucerization

Ewing's Sarcoma

Aberrant notochordal cell tumor \> 40 yo MC found in the sacrum 2nd MC location is the skull

Chordoma