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Musculoskeletal > Bone Tumors- Handorff > Flashcards

Bone Tumors- Handorff Flashcards

1
Q

What are the four pieces of information you need when attempting to identify a bone lesion/tumor?

A

Age and sex of pt, location of lesion, radiographic appearance of lesion

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2
Q

Malignant tumor of the skull or lumbar vertebrae

A

chordoma

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3
Q

Benign tumor of the spinal cord=

A

osteoblastoma

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4
Q

Malignant bone lesion of the shoulder=

A

osteosarcoma

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5
Q

malignant lesion of the pelvis=

A

chondrosarcoma

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6
Q

Malignant lesion of the head of the femur or radius=

A

Giant cell tumor…and most are actually benign

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7
Q

Also look at the diagram for non-malignants

A

ok

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8
Q

Malignant bone tumors occuring in the metaphysis are?

A

Osteosarcoma and juxtacortical osteosarcoma

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9
Q

Malignant tumors occuring in the diaphysis include

A

Ewing’s Sarcoma and chondrosarcoma

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10
Q

Bnign tumors occuring at the epiphysis include…

A

Chondroblastoma and Giant cell Tumor

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11
Q

Benign tumors in the diaphysis include

A

Enchondroma and fibrous dysplasia

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12
Q

What is the issue in fibrous dysplasia?

A

All components of the bone are present but do not mature

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13
Q

What are the 3 distinctive patterns of bone involvement?

A

monostotic, polyostotic, McCune Albright SYndrome

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14
Q

What is monostotic fibrous dysplasia

A

characterized by single bone involvement

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15
Q

What is polyostotic fibrous dysplasi

A

characterized by multiple bones being involved

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16
Q

McCune Albright Syndrome

A

Polyostotic, Cafe-Au Lait skin pigmentation, Endocrinopathies

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17
Q

Polyostotic fibrous dysplasi may transform to?

A

Osteosarcoma

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18
Q

x-ray appearance of a fibrous cortical defect?

A

scooped out with borders that are scalloped and sclerotic/ denser than the bone which surrounds them

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19
Q

Is a fibrous cortical defect common or uncommon

A

COMMON. over 50% of kids over 2

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20
Q

Most common site of fibrous cortical defect

A

Metaphysis of femur and proximal tibia

Approximately half of these are bilateral or multiple

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21
Q

If you see that the fibrous cortical defect is over 5-6 cm, what do you suspect?

A

nonossifying fibroma

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22
Q

Fibrous cortical defects ususally resolve…..

A

spontaneously

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23
Q

Definition of fibrous cortical defect

A

eccentric, sharply delineated, metaphyseal lesion in long bones of adolescents…Also known as benign fibrous histiocytom is mass forming

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24
Q

Fibrous cortical defect age group

A

adolescents

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25
Q

Symptoms of FCD

A

pain

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26
Q

Solitary bone cysts are benign fluid-filled cysts

A

truth

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27
Q

2/3 of solitary bone cysts occur where?

A

in the humerus or femur

28
Q

Solitary bone cysts are usually asymptomatic

A

true

29
Q

Very bloody cystic lesion=

A

aneurysmal bone cyst

30
Q

Aneurysmal bone cysts are not true tumors, they arise from the surface of bone and are usually found in the long bones and vertebral column.

A

all true

31
Q

Greatest frequency of bone neoplasms is when?

A

First 3 decades of life

32
Q

What type of benign neoplasm may become malignant?

A

Chondroma

33
Q

Osteomas are

A

bone forming tumors

34
Q

Osteomas are generally solitary unless….

A

Gardners Syndrome, multiple osteomas and GI nodules

35
Q

Osteomas are of little clinical significance unless they are where

A

in the skull eye, oral cavity, etc…)

36
Q

Osteoid Osteomas are generally what size, seen in what age groups, involve what bones?

A

less than 2cm, involve mostly males in their teens and twenties, involve tibia and fibula

37
Q

Osteoid osteomas are……..

A

PAINFUL!!! They secrete prostaglandin E2 and have a characteristic pattern of pain. Most commonly painful at night are relieved by asprin

38
Q

Intake of alcohol causes a massive increase in pain in….

A

osteoid osteomas

39
Q

Osteochondromas are what:

A

benign cartillage capped tumors that are attached to underlying skeleton by a stalk.
They may displace growth plates in endochondral bones

40
Q

What is multiple hereditary exostosis

A

a condition characterized by multiple osteochondromas, it is autosomal dominant and may give rise to malignant chondrosarcoma (rare)

41
Q

Chondroma

A

benign tumor of hyaline cartillage

42
Q

Enchondromas are where

A

arise in medullary cavity of hands and feet

43
Q

Juxtacortical chondromas arise where

A

surface of bones

44
Q

Ollier disease

A

multiple enchondromas

45
Q

Maffucci syndrome

A

multiple enchondromas as well as hemangiomas

46
Q

Giant cell tumor definition, location, age

A

multinucleated osteoclast giant cells, benign but uncommon and locally aggressive, arise in ppl age 20-40’s. Arise around the knee

47
Q

WHat must you not confuse giant cell tumors with?

A

TB, if it is a granuloma think TB

48
Q

Malignant bone tumors are rare:

A

Truth

49
Q

The most common bone tumors are:

A

Metastatic, BPLKT, Breast, Prostate, lung, kidney, thyroid…KNOW

50
Q

Finish bone tumors

A

ok

51
Q

Osteosarcoma generally appears in what age group

A

under 20.

52
Q

Where in the body does osteosarcoma most commonly appear

A

Knee, shoulder, pelvis. Or as Robbins puts it, the METAPPHYSIS of distal femur, humerus, and proximal tibia

53
Q

Osteosarcoma has the tendency to grow out of the cortex and do what to the periosteum? What does this form?

A

Lift it, forms a codman triangle

54
Q

Chondrosarcoma occurs where most frequently

A

SHoulder, pelvis, proximal femur, rib

Very centrally located.

55
Q

WHat is the age range for chondro sarcoma

A

35-60,

56
Q

Treatment for chondrosarcoma?

A

Surgery, it is insensitive to radiation and chemo

57
Q

Ewing Sarcoma most commonly affects who>

A

Children. …white ppl under 15 specifically

58
Q

Ewing’s sarcoma typically arises where?

A

diaphysis of long bone

59
Q

Gross appearance of Ewing’s

A

Onion skin with layers of reactive periosteum and neoplasm

60
Q

Ewing’s on Histology

A

“Small round blue cells”

61
Q

What is the characteristic structure of Ewing’s sarcoma

A

Homer Wright rosettes: tumor cells arranged in a circle around a central fibrillary space….Dark blue cells around a pink fibrillar area

62
Q

In adults, more than 75% of skeletal metastases come from where?

A

cancer of prostate, breast, kidney, lung

63
Q

In children, metastatic metastses to the skeleton are from:

A

neuroblastoma, wilms tumor, osteosarcoma, Ewing sarcoma, rhabadomyosarcoma

64
Q

Most metastases involve what part of the skeletal structure

A

Axial skeleton, proximal femur, humerus, in descending order

Most include a mixed lytic and blastic reaction…(break boine and make bone).

65
Q

Key words for metastasis?

A

Multiple lytic punched out lesions!

Musculoskeletal (23 decks)

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