Bone Tumors Flashcards
Bosselated, round sessile tumor projecting from the subperiosteal surface on or inside the skull and facial bones in middle aged adults
Osteoma
What is the osteoma composed of?
Woven or lamellar bone
Trabecular bone with marrow
Happens in teens and 20s
Worse at night
Relieved by NSAIDs
Arises in femur or tibia
Osteiod osteoma
What is a osteoblastoma composed of?
Woven bone and osteoblasts with stroma of loose CT and dilate congested capillaries
Radiation promotes malignancy
Nidus
Need to resect to prevent recurrence
Osteoid osteoma/osteoblastoma
How is an osteoblastoma different from and osteoid osteoma?
The pain is dull and achy
It doesn’t respond to NSAIDs
Involved the spine
What is the most common primary malignancy of bone?
Osteosarcoma
What are the genetic mutations associated with osteosarcoma?
Rb P53 Cdk4 P16 Ink4a cyclin d1 Mdm2
Who gets osteosarcoma?
75% younger than 20
And the elderly with paget’s, irradiation, bone infarcts
Men
Where is it most likely to show up?
In the metaphysis of long bones intramedullary - around the knee
Forms bone with coarse lace like architecture, destroys cornices and produces soft tissue mass
X-ray: shows lytic and blastic lesions
Codman’s triangle
Osteosarcoma
What other disease is osteosarcoma associated with?
Polyostotic paget’s
Poor prog
Benign cartilage capped outgrowth near the growth plate of long tubular bones
Osteochondroma
Mushroom shaped Benign hyaline cartilage cap Painful if impinged in nerves or stalk is fractured Auto Dom Late adolescence Men
Osteochondroma
What is the most common intraosseous cartilage tumor?
Chondroma
Solitary, short tubular bones of hands and feet
Gray blue tumor
Chondroma
What is Ollier disease?
Multiple endochondromas
What is maffucci syndrome?
Endochondromatosis and soft tissue hemangiomas
Can lead to ovarian carcinoma and brain gliomas
O ring sign on X-ray
Neoplastic chondrocytes that reside in lacunae
Unmineralized Nodules of cartilage on X-rays
Chondroma
In young teens, males more than females
Epiphysis and apophyses
Composed of sheets of chondroblasts
Hyaline matrix with lace like configuration = chicken wire
Chondroblastoma
X-ray shows spotty calcification
Painful with effusion and restrict joint mobility
Chondroblastoma
Arise in metaphysis of long bones
Has chondrocytes in lacunae and stellate cells in the myxoid area
Chondromyxoid fibroma
Dull achy pain
X-rays : eccentric geographic lucency with well delineated from adjacent bone by rim of sclerosis
No malignant transformation
Chondromyxoid fibroma
Produces neoplasticism cartilage
Large bulky tumor of malignant hyaline and myxoid cartilage
Spotty calcification with central necrosis
Chondrosarcoma
Broad pushing fronts
Arise in central skeleton
Different variants
Chondrosarcoma
What clear cell chondrosarcoma?
Sheets of large malignant chondrocytes with abundant clear cytoplasm, intralesional reactive bone formation
Seen in teens
In epiphysis of long bones
Islands of well differentiated hyaline cartilage with sheets of small round cells
Teens
Mesenchymal chondrosarcoma
What is the most common tumor of adulthood?
Lipoma
Doughy
Subcutis
Mobile painless mass
Lipoma
Arise in deep soft tissues of proximal extremities and retroperitoneum
Has lipoblasts
Pleomorphic variants and round cell variants are aggressive with frequent mets
Liposarcoma
Most common in the lower extremities
Translocation to ch.18 produces fusion of SYT-SSX1/2
Most common in 20s to 40s
Synovial sarcoma
Biphasic differentiation: epithelial cells and spindle cells
Calcified concretions on X-rays
Rxns for keratin and epithelial membrane Ag
Synovial sarcoma
What is the most common neoplasm in women?
Leiomyoma
Spindle cells intersecting at right angles
Arise in uterus nipples, scrotum
Blunt ended, elongated nuclei
Leiomyoma
Females
Develop in the skin and deep soft tissues of extremities and retroperitoneum
Cigar shaped nuclei
Malignant SMCs with dense bodies and pinocytotic vesicles
Leiomyosarcoma
Stain with abs for vimentin, actin, SM actin, desmin
Leiomyosarcoma
What is the most common soft tissue sarcoma of childhood?
Rhabdomyosarcoma
Translocation 2;13 = PAX3 fuses with FKHR — dysregulation of muscle differentiation
Eccentric Eosinophilic granular cytoplasm rich in thick and thin filaments
Rhabdomyosarcoma
Tadpole or strap cells
Sarcomeres stain with Ab to desmin, MYOD1, myogenin
Rhabdomyosarcoma
What is the rhabdomyosarcoma variant with the worst prognosis?
Botryroid variant
Embryonal
Pleomorphic
Alveolar
Children younger than 10
Grape like lesions in mucosal cavities
Allelic loss of ch.11p15.5
Cambium layer with hypercellularity
Embryonal rhabdomyosarcoma
Sarcoma Botryoides
Resembles pulmonary alveolae
Cells with cross-striation
Has t(2;13) or (1;13)
In early to mid adolescence
Alveolar rhabdomyosarcoma
