Bone tumors Flashcards
What are the different patterns of bone destruction (3)
- Geographic: well-defined, short zone of transition= benign/low grade malignancy
- Moth-eaten: more aggressive, intermediate zone of transition =benign or malignant
- Permeative: poorly-defined, wide zone of transition =malignant
What are the different patterns of periosteal reactions (5)
- Single layer: benign but sometimes malignant
- Onion skin: malignant, multiple layers of periosteum
- Sunburst: spiculated rays
- Hair on end: parallel rays
Codman triangle: triangular elevation of periosteum
Name benign bone tumors of the foot (11)
FOG MACHINES
F- fibrous dysplasia O-osteochondroma G- Giant cell tumor M-Myeloma A- aneurysmal bone cyst C- chondroblastoma, chondromyxoid fibroma, clear cell H- Hemangioma I-infection N- non-ossifying fibroma E-eosinophilic granuloma, echondroma, epidermal inclusion cyst S- solitary bone cyst
Name malignant bone tumors of the foot (6)
COPE MF
- Chondrosarcoma
- Osteosarcoma
- Periosteal sarcoma
- Ewings Sarcoma
- Multiple Myeloma
- Fibrosarcoma
What is the most common, benign, primary bone tumor
Osteochondroma
What is the most common, malignant bone tumor
multiple myeloma
What primary bone tumors are more frequent in females (3)
Giant cell tumor
ABC
Periosteal osteosarcoma
What are the most common cancers that metastasize to foot (4)
- breast
- prostate
- lung
- kidney
What bone tumors do not form matrix
Bone cysts
Ewings sarcoma
Giant cell tumor
Where are bone tumors typically located (7)
- Epiphysis
- metaphysis
- diaphysis
- centrally located
- eccentrically located within medullary canal
- cortical
- periosteal
Which tumors are located in the epiphysis (2)
- Chondroblastoma
- Giant Cell tumor
Which tumors are located in the metaphysis(9)
- Enchondroma
- Osteochondroma
- Nonossifying fibroma
- unicameral bone cyst
- Aneurysmal bone cyst
- Giant cell tumor
- Medullary osteosarcoma
- Periosteal osteosarcoma
- chondrosarcoma
Which tumors are located in the diaphysis (5)
- Osteoid osteoma
- Osteoblastoma
- Enchondroma
- Ewings sarcoma
- Periosteal osteosarcoma
Centrally located (2)
Enchondroma
Unicameral bone cyst
Eccentrically located within medullary canal (3)
- Giant cell tumor
- Chondrosarcoma
- Osteosarcoma
Cortical (2)
Osteoid osteoma
Nonossifying fibroma
Periosteal
Osteochondroma
Periosteal osteosarcoma
What are the characteristics of an osteoid osteoma (3)
- benign, osteolytic lesion with central nidus (<1cm) that may have calcifications
- 1st- 2nd decade of life
- dull pain, worse at night, relieved with ASA
What are characteristics of an osteoblastoma (5)
- Giant osteoid osteoma
- benign tumor that may become malignant
- osteolytic lesion with well-circumscribed nidus (>1.5 cm) that may have multiple calcifications
- 2nd to 3rd decades of life
- Less symptomatic than osteoid osteoma, pain not relieved by ASA.
What are some characteristics of an echondroma (4)
- benign, well defined, intramedullary, cartilaginous lesion
- geographic lesions with punctuate calcified matrix
- 3rd/4th decades of life
- painless swelling unless pathologic fractures
What is Ollier disease(3)
Multiple enchondromatosis
may become malignant
1st decade of life
What is Maffuccis disease (3)
- multiple enchondromas with soft tissue hemangiomas
- most malignant
- 1st decade of life
What are characteristics of a chondroblastoma (3)
- benign, geographic, osteolytic, lesions with sclerotic margins
- 2nd/3rd decade of life
- pain and joint effusion
What are characteristics of an osteochondroma (4)
- most common benign primary bone tumor
- cartilage-capped, hyperplastic bone pointing away from the joint
- 2md/4th decades of life
- suspect malignant transformation with growth after skeletal maturity, pain or cap >2cm
What are characteristics of nonossifying fibromas (5)
- benign connective tissue lesion with fibrous replacement of bone
- Expansive, radiolucent medullary lesions
- 1st/2nd decades of life
- Lesions typically resolve with age
- do not biopsy
What are the characteristics of a fibrous dysplasia (3)
- benign, geographic, medullary lesion with ground glass matrix
- presents with deformity
- sometimes painful secondary to fracture
What are characteristics of a unicameral bone cyst (5)
- benign, geographic, medullary lesion that is fluid filled
- commonly found in calcaneus
- fallen fragment sign: pathologic fracture in which cortex lies within lesion
- 1st/2nd decades of life
- asymptomatic until fracture
What are the characteristics of an aneurysmal bone cyst (6)
- benign, expansile, lytic lesion with blood-filled cavities
- may extend into soft tissue
- fluid levels sen on MRI
- 1st/3rd decades of life
- common in females
- painful, especially with pathologic fractures
What are characteristics of giant cell tumor (5)
- benign but locally aggressive, lytic lesions with ground glass, “soap bubble” appearance.
- May destroy cortex and have soft tissue mass
- more common in females
- 3rd/4th decades of life
- painful
What are the characteristics of a multiple myeloma (5)
- most common primary malignant bone tumor
- punched out lesions or diffusely osteopenic with hair on end radiating spicules
- affect 45-80 year olds
- painful with weakness or neurologic symptoms
- Bence Jones protein found within the urine
What are the characteristics of an osteosarcoma (7)
- Most common primary malignant bone tumor
- sunburst periosteal reaction with Codman triangle and cloud-like
- 2nd/3rd decades of life
- dull aching pain
- In medullary (bad prognosis)
- In parosteal (better prognosis)
- periosteal (slight better prognosis than medullary)
What is the most common bone tumor associated with Paget disease
Osteosarcoma
What are some characteristics of a Ewings sarcoma (6)
- common, malignant, primary bone tumor
- aggressive, permeative, lytic lesion with hair on end, Codman triangle, and onion skin
- may have large soft tissue mass
- usually under 20 year
- Painful with fever, weight loss and elevated ESR
- Poor prognosis
What are characteristics of a chondrosarcoma (4)
- common, malignant, moth-eaten, lesion with medullary and soft tissue calcifications
- may arise from malignant transformation of enchondromas or osteochondromas
- 5th/6th decades of life
- painful
What study is the most useful in searching for metastatic bone disease
Total skeletal bone scan
malignant lesions will show increased uptake
