Bone Tumors Flashcards
What are the three patterns of bone destruction seen with bone tumors?
Moth eaten: More agressive, intermediate zone of transition, benign or low-grade malignancy.
Geographic: Well-defined, short zone of transition, benign or low grade malignancy.
Permeative: Poorly-defined, wide zone of transition, malignant.
What is a geographic lesion?
A well defined area with short zones of transition.
Correlates to a benign or low grade malignancy.
What is a Moth-Eaten lesion?
A more agressive form of tumors with an intermediate zone of transition.
Correlates to a benign or malignant tumor.
What is a permeative bone lesion?
A poorly defined lesion with a wide zone of transition.
Most commonly correlates to a malignant tumor.
What is onion skinning?
A form of periosteal reaction seen with bone tumors.
Is most commonly malignant with multiple layers of periosteum.
What is sunburst patterning?
This is a type of periosteal reaction in which there are spiculated rays within the bone.
What is a hair on end patterning?
Hair on end patterning shows parallel rays along the periosteum.
What is Codman’s triangle?
A form of periostitis in which there is a triangular elevation of periosteum.
F O G M A C H I N E S
Benign bone tumors of the foot!
Fibrous dysplasia Osteochondroma Giant cell tumor Myeloma Aneurysmal bone cyst Chondroblastoma, chondromyoid fibroma, clear cell Hemangioma Infection Non-ossifying fibroma Eosinophillic granuloma, enchondroma, epidermal inclusion cyst Solitary bone cyst
Name the malignant bone tumors of the foot
Chondrosarcoma Osteosarcoma Periosteal sarcoma Ewings sarcoma Fibrosarcoma Multiple myeloma
What is the most common benign primary bone tumor?
Osteochondroma
What is the most common, malignant primary bone tumor?
Multiple myeloma
What three primary bone tumors are more common in females?
Giant cell tumor
ABC
Parosteal osteosarcoma
What are the most common cancers that metastasize to the foot?
Breast, prostate, lung, kidney
What bone tumor is described as being benign with dull pain that is worse at night and relieved with ASA
Osteoid osteoma
What differentiates osteoid osteoma from osteoblastoma?
Osteoblastoma starts benign and can become malignant.
It is less symptomatic than osteoid osteoma, PAIN IS NOT RELEIVED BY ASA
What is Ollier disease?
Multiple enchondromatosis
May become malignant and is seen in the first decade of life.
What is Maffuccis disease?
Multiple enchondromas with soft tissue hemangiomas
Most become malignant presenting in the first decade of life.
Cartilage capped hyperplastic bone pointing away from the joint.
Osteochondroma
What are the characteristics of a fibrous dysplasia?
Benign, geographic, fibro-osseous lesion with GROUND GLASS MATRIX
What are the characteristics of a unicameral bone cyst?
Benign, geographic, medullary lesion that is fluid-filled
Commonly found in the calcaneus
“Fallen fragment sign” Fracture in which the cortex lies within the lesion.
Lytic bone lesion with ground glass, “Soap bubble” appearance
Giant cell tumor
Punched out lesions or diffusely osteopenic with hair on end radiating spicules
Multiple myeloma!!
Most common primary malignant bone tumor.
Suburst periosteal reaction with codman triangle and cloud-like, dense bone formation
Osteosarcoma!
Most common primary malignant bone tumor
What is the most common bone tumor associated with Pagets disease
Osteosarcoma
Agressive bone tumor that is permeative, lytic, with hair-on-end, codman triangle and onion skinning
“Wings and Onion Rings”
Ewings Sarcoma!!
Usually under 20 y/o, painful with fever, weight loss, and elevated ESR.
What study is most useful in searching for metastatic bone disease?
Total skeletal bone scan
Malignant lesions will show increased uptake
