Bone Tumors

Question 1

What is a osteoma?
Where is it found in the skeleton?
What syndrome is it associated with and what 3 clinical features make up the syndrome?

Answer 1

Benign tumor of bone
Facial bones
Gardner syndrome. Polyps, fibromatosis, and osteoma of the face.

Question 2

How do we characterize osteoid osteoma?
What patient population is it most commonly seen in?
Where is it found in the skeleton?
What is an important identifying clinical feature?
What does x ray show?

Answer 2

Benign tumor of osteoblasts that produce osteoid that gets surrounded by a rim or ring of reactive bone.
Young adults, most males
In the cortex of long bones, in the diaphysis area
Bone pain is resolved with aspirin
Bony mass with a white core. Target sign kind of.

Question 3

What are the 3 main ways an osteoblastoma is different than an osteoid osteoma?

Answer 3

Larger, greater than 2cm
Arises in the vertebrae
Bone pain that does not resolve with aspirin

Question 4

Explain how an osteochondroma arises and what does it look like?
What is it the most common of?
What can it transform into?

Answer 4

Lateral projection of the growth plate, metaphysis, which essentially creates a projected bone with a cartilage cap/
Most common benign tumor of bone
Chondrosarcoma

Question 5

How do we characterize osteosarcoma?
What are the two peak incidences, which one is more common and what are the risk factors for each?
Where in the body does it usually arise?
2 clinical features?
What does x ray show?
Biopsy shows what?

Answer 5

Malignant proliferation of osteoblasts
Teens and elderly. Teens more common. Familial retinoblastoma is risk factor for teens. Radiation exposure and paget disease for elderly.
Metaphysis of long bones, usually distal femur/proximal tibia
Bone pain with swelling or fracture
Destructive mass with sun rays appearance. Also the periosteum is being pulled away called codman triangle.
Pleomorphic cells producing osteoid

Question 6

Young Adult presents with tumor in epiphysis of distal femur/proximal tibia. X ray shows soap bubble appearance. What is the diagnosis most likely?

Answer 6

Giant cell Tumor

Question 7

How do we characterize Ewing sarcoma?
Where does it arise in the skeleton and what patient population?
What will x ray show?
What will biopsy show and why is this significant?

Answer 7

Malignant proliferation of poorly differentiated cells from neuroectoderm
Diaphysis of long bones, male kids
Onion skin appearance as the periosteum continues to lay down new bone because of the pressure of the tumor pushing out on the bone
Small, round blue cells that look like lymphocytes so you need to rule our osteomyelitis and lymphoma. The way we do this is with the charactertis translocation of Ewing sarcoma which is 11:22.

Question 8

What is the difference between a chondroma and chondrosarcoma?

Answer 8

Benign tumor of cartilage most commonly seen in medulla of small bones of hands and feet
Malignant tumor of cartilage in the medulla of the pelvis or central Skelton.

Question 9

Are primary or metastatic tumors of bone more common? What is the effect on bone usually from metastatic tumors? What is the one exception to this?

Answer 9

Metastatic are more common
Punched out lytic lesion
Prostate carcinoma classically produces osteoblastic lesions