Bone tumors Flashcards
Ends in -oma
benign
except melanoma, lymphoma (hodgkin’s), and gliomas
Ends in -sarcoma
Malignant
glandular
Where are the malignancies usually taken place in sarcomas
bone cartilage fat muscle glands blood vessels
What is important about primary bone tumors
They are less common than tumors that metastasize to the bones
e.g. to the spine from prostate adenocarcinoma
Osteoma
benign
lesions in bone
non invasive
location of osteoma
head and neck
Osteomas lesions are unique in that they….
ATTACH TO THE BONE
NOT part of the BONE
2 types of osteomas
osteoid osteoma
osteoblastoma
Differentiate osteoid osteoma and osteoblastoma
Osteoid osteoma is in tibia and femur - will see bump on the bone with X-ray
PAIN
Osteoblastomas - large and located in the spine
PAIN
Which one of the osteomas cause pain but NSAIDs don’t relieve the pain?
osteoblastoma
osteosarcomas
Primary ones are usually found above and below the knee
DONT develop from osteomas
if found in the rib area, may want to look elsewhere (the knees) because it may be a secondary nodules
Secondary Osteosarcomas
result of paget’s
aggressive ! comes back quickly as opposed to primary osteosarcomas
patients will secondary osteosarcomas must be monitored
Hx is very important!!!
What is the most common BENIGN bone tumor?
osteochondroma
Male patient in 2nd decade with nodules above and below the knee
primary osteosarcoma
A 50 y/o patient presents with multiple lesions in the hands and feet. The patient had a fx in one of the fingers. It was found that mature hyaline cartilage were found in the small bones of the hands and feet.
Oller’s chondroma
What is the cartilage in chondroma
hyaline
Where does chondroma usually take place?
hands and feet
Differentiate between Ollier’s and Maffucci chondroma
Angioma (vessels) is formed at the hands in maffucci chondroma
A major problem with ollier’s chondroma is that it develops
into chondrosarcoma
Differentiate between chondromas and chondrosarcomas
Chondromas affect people in their 30-50s
Chondrosarcomas affect people in their 60s
Chondromas are located at the hands and feet
Chondrosarcomas are located at the pelvis and shoulder girdle
A patient presents with a X-ray that shows growth in the epiphyseal plate of the tibia.
idiopathic tumor
called giant cell tumor of bone
always at the epiphyseal plate
aggressive BENIGN tumor
What type of tumor is giant cell tumor of the bone
benign but aggressive
growth on the epiphyseal plate of the tibia
Ewing sarcoma family of tumors
Think of the kid with giant tumor on the femur
A boy dies of a tumor of the femur (which can also grow at the pelvis)
Ewing sarcoma
has family component to it - gene translocation
undifferentiated is BAD
differentiated vs undifferentiated ewing sarcoma
undifferentiated is BAD
-usually death
which cells make hyaline cartilage at the articular tissue of the joints?
chondrocytes
a 10 year with large joints presents to the doctor
No psoriasis or ankylosing arthritis (NO HLA-B27)
This is juvenile RA, which is differentiated from RA in adults because of the large joints instead of hands and feet
also adult RA has ankylosing in the hands
Juvenile RA is similar to pseudogout
because it affect large joints but they are different by the nature of disease
also the AGE
Psuedogout vs gout
affect large joints instead of big TOE
calcium deposits instead of monosodium urate seen in normal gout
affect people in their 50s
Pseudogout
THINK ACUTE INFLAMMATION
in large joints because calcium deposits in the intraarticular areas in the cartilage
juvenile RA
before age 16
Gout
big toe
acute inflammation - there will be neutrophils
IL-8
overproduction of uric acid and normal excretion (common) or abnormal excretion with normal production of uric acid
HUMANS don’t have uricase to break it down so it accumulates in the joints
What is the role of monosodium uracate in gout
it accumulates and is a chemotactic factor that recruits neutrophils to the site
Adult RA
RA factor
CHRONIC inflammation
angiogenesis and fibroblasts at the site
ankylosis happens = bones anchored together (not due to HLA -B27)
RA is autoimmune disease with HLA association of DR4
What is found in the synovium of joints in RA
CD4+ cells
Osteoarthritis
breaking down type II collagen (cartilage)
hyaline cartilage
bone ends rub together
secondary arthritis from other diseases
Osteoarthritis and inflammation
NOT AN INFLAMMATORY DISEASE
can progress to RA
Osteoarthritis
strictly a geriatric disease
What cells are affected in OA
chondrocytes
What are the risks of developing OA?
low estrogen (IL-1) low bone density!!!!! (osteoporosis?)
