Bone Tumors Flashcards
How do bone tumors usually present?
nonspecific!
pain (worse at ngiht)
mass
pathologi fracture
aymptomatic
What ae the diagnostic factors from bone tumors?
- age
- sex
- skeletal location
- specific bone
- specific area of bone
- medullary cavity, cortex, juxtacortical
- epiphysis, metaphysis, diaphysis
What bone tumors are common in
children?
young adults?
elderly?
Children, adolecents: osteosarcoma, Ewing’s sarcoma
Young adults: Giant cell tumor
Elderly: Chondrosarcoma
What is a sclerotic (well-defined) margin in a radiologic pattern typically an indication of?
a benign, slowly growing neoplasm
what is an illdefined margin radiologically typically an indication of?
malignant, rapidly growing neoplasm
hat is a solid ivory pattern typically and indicator of?
malignant bone-matrix forming tumors
what are rings and arcs typically an indicator of
chondroid matric fomring tumors
what are 2 benign bone forming tumors and what are the differences in type of bone, size, pain and response to aspirin
- Osteoid Osteoma
- long bones, femur and tibia
- less than 2cm
- night pain
- responds to aspirin
- radiolucent lesion within sclerotic cortex
- Osteoblastoma
- vertebrae or long bone metaphysis
- more than 2 cm
- painful
- not responsive to aspirin
- expansile radio-lucency with mottling
what is this?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/515/q_image_thumb.png?1536206593)
Osteoid osteoma
central area of immature bone formation. they are all osteoblasts that are producing osteoid that is becoming poorly formed bone
What is this?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/520/q_image_thumb.png?1536206610)
osteoid osteoma- note the osteoblasts look normal!!
WHat is this?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/536/q_image_thumb.png?1536206655)
osteoblastoma
- histologically siilar to osteoid osteoma
- circumscribed benign lesion in bone
- look like osteoid/osteoma
- area of immature bone being formed by osteoblats
What are bone-forming (osteogenic) tumors?
- rare group of tumors in comparison with carcinomas and hematopoietic tumors bc malignant bone tumor comprise 0.2% of all types of cancers
- represent an important percentage of potentially curable cancers following a multimodal therapy
Define the pathogenesis of an osteosarcoma:
- inherited mutant allele of Rb gene (hereditary Rb: marked increase (1000x) in OS
- mutation of p53 supressor gene
- Li-FraumeniL bone and soft tissue sarcomas, easryl onset breast cncer, brain tumors, leukemia
- Over expression of MDM2 (5-10%) INK4 and p16
- site of bone growht/disease (is pagez)
- prior irradiation
What is an osteosarcoma and what is the incdence and age distribution
- malignant mesenchymal tumor in which cells produce osteoid or bone
- 2000 new a year
- mos tcommon sarcoma of bone
- bimodal age distribution: M>F mean age is 15 2nd peak is 55-80
Where does an osteosarcomea usually ocur? where is spread common
- metaphysis of long bones
- femur, tibia, humerus, flat bones, spine (sometime polyostotic but usually not)
- Hematogenous spread to lungs is common (if not treated will happen for sure)
what are some characteristic of an osteosarcoma?
- poorly delineated
- bone destruction
- cortical disruption
- bone matrix
- soft tissue extension
- codman’s triangle (bone trying to make new cortex around the tumor)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/617/a_image_thumb.png?1536207019)
What is the pathology of an osetosarcoma and what is the treatment?
- pathology: infiltrative tumor, extending into soft tissue, malignant cells producing osteoid
- treatment: neo-adjuvant chemotherapy and surgical resection
- prominent irregularly shaped nuclei a lot of mitotic activity that are often atypical, pleomorphism seen histologically
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/623/a_image_thumb.png?1536207208)
what is the prognosis of an osteosarcoma?
- post chemo: 60-65% 3-5 yr survivl for pts with non-metastatic disease
- En bloc resection following chemotherapy: >90% necrosis which leads to near 90% survival
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/650/a_image_thumb.png?1536207291)
What is an osteochondroma?
- the most common benign tumor of bone
- metaphysis of long bones
- malignancy is rare but increased risk in herditary multiple extoses
- autosomal dominant, usualyl EXT-1 (8q24)
- small growth that comes off the cortex with a cartilagenous cap
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/715/a_image_thumb.png?1536207408)
What is this?
![](https://s3.amazonaws.com/brainscape-prod/system/cm/252/939/734/q_image_thumb.png?1536207438)
where the cartilage cap is forming just looks like normal cartilage!
What is an enchondroma?
benign hyaline cartialge lesion
- enchondroma: intramedullary chondroma
- periosteal chondroma: juxtachortical chondroma (ie located on the cortica surface under the periosteum)