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Crozer Surgery > Bone tumors > Flashcards

Bone tumors Flashcards

1
Q

What are the different patterns of bone destruction (3)

A
  • 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
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2
Q

What are the different patterns of periosteal reactions (5)

A
  • 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

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3
Q

Name benign bone tumors of the foot (11)

A

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
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4
Q

Name malignant bone tumors of the foot (6)

A

COPE MF

  • Chondrosarcoma
  • Osteosarcoma
  • Periosteal sarcoma
  • Ewings Sarcoma
  • Multiple Myeloma
  • Fibrosarcoma
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5
Q

What is the most common, benign, primary bone tumor

A

Osteochondroma

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6
Q

What is the most common, malignant bone tumor

A

multiple myeloma

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7
Q

What primary bone tumors are more frequent in females (3)

A

Giant cell tumor
ABC
Periosteal osteosarcoma

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8
Q

What are the most common cancers that metastasize to foot (4)

A
  • breast
  • prostate
  • lung
  • kidney
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9
Q

What bone tumors do not form matrix

A

Bone cysts
Ewings sarcoma
Giant cell tumor

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10
Q

Where are bone tumors typically located (7)

A
  • Epiphysis
  • metaphysis
  • diaphysis
  • centrally located
  • eccentrically located within medullary canal
  • cortical
  • periosteal
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11
Q

Which tumors are located in the epiphysis (2)

A
  • Chondroblastoma

- Giant Cell tumor

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12
Q

Which tumors are located in the metaphysis(9)

A
  • Enchondroma
  • Osteochondroma
  • Nonossifying fibroma
  • unicameral bone cyst
  • Aneurysmal bone cyst
  • Giant cell tumor
  • Medullary osteosarcoma
  • Periosteal osteosarcoma
  • chondrosarcoma
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13
Q

Which tumors are located in the diaphysis (5)

A
  • Osteoid osteoma
  • Osteoblastoma
  • Enchondroma
  • Ewings sarcoma
  • Periosteal osteosarcoma
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14
Q

Centrally located (2)

A

Enchondroma

Unicameral bone cyst

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15
Q

Eccentrically located within medullary canal (3)

A
  • Giant cell tumor
  • Chondrosarcoma
  • Osteosarcoma
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16
Q

Cortical (2)

A

Osteoid osteoma

Nonossifying fibroma

17
Q

Periosteal

A

Osteochondroma

Periosteal osteosarcoma

18
Q

What are the characteristics of an osteoid osteoma (3)

A
  • benign, osteolytic lesion with central nidus (<1cm) that may have calcifications
  • 1st- 2nd decade of life
  • dull pain, worse at night, relieved with ASA
19
Q

What are characteristics of an osteoblastoma (5)

A
  • 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.
20
Q

What are some characteristics of an echondroma (4)

A
  • benign, well defined, intramedullary, cartilaginous lesion
  • geographic lesions with punctuate calcified matrix
  • 3rd/4th decades of life
  • painless swelling unless pathologic fractures
21
Q

What is Ollier disease(3)

A

Multiple enchondromatosis

may become malignant

1st decade of life

22
Q

What is Maffuccis disease (3)

A
  • multiple enchondromas with soft tissue hemangiomas
  • most malignant
  • 1st decade of life
23
Q

What are characteristics of a chondroblastoma (3)

A
  • benign, geographic, osteolytic, lesions with sclerotic margins
  • 2nd/3rd decade of life
  • pain and joint effusion
24
Q

What are characteristics of an osteochondroma (4)

A
  • 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
25
Q

What are characteristics of nonossifying fibromas (5)

A
  • 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
26
Q

What are the characteristics of a fibrous dysplasia (3)

A
  • benign, geographic, medullary lesion with ground glass matrix
  • presents with deformity
  • sometimes painful secondary to fracture
27
Q

What are characteristics of a unicameral bone cyst (5)

A
  • 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
28
Q

What are the characteristics of an aneurysmal bone cyst (6)

A
  • 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
29
Q

What are characteristics of giant cell tumor (5)

A
  • 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
30
Q

What are the characteristics of a multiple myeloma (5)

A
  • 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
31
Q

What are the characteristics of an osteosarcoma (7)

A
  • 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)
32
Q

What is the most common bone tumor associated with Paget disease

A

Osteosarcoma

33
Q

What are some characteristics of a Ewings sarcoma (6)

A
  • 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
34
Q

What are characteristics of a chondrosarcoma (4)

A
  • 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
35
Q

What study is the most useful in searching for metastatic bone disease

A

Total skeletal bone scan

malignant lesions will show increased uptake

Crozer Surgery (16 decks)

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