Bone Tumors of Unknown Origin

Question 1

What race/age group gets Ewing Sarcoma Family Tumors?

Answer 1

WHITE people less than 20 yo

Question 2

What are the histological features of Ewing Sarcomas?

Answer 2

Small blue round cell tumor

– Homer-Wright Rosettes

Question 3

How do Ewing Sarcomas present?

Answer 3

Painful, tender, warm, swollen mass

– Mimics Infection!

Question 4

How do Ewing Sarcomas present?

Answer 4

White young person with a painful, tender, warm, swollen mass that mimics an infection

Question 5

What reaction takes place with Ewing Sarcomas?

Answer 5

Periosteal reaction

Question 6

How do Ewing Sarcomas look on x-ray?

Answer 6

Onion skin fashion reactive bone

Question 7

Onion skin reactive bone on x-ray is likely a?

Answer 7

Ewing Sarcoma

Question 8

Where are Ewing Sarcomas usually located?

Answer 8

Femur (long bones) medullary cavity and invades outer structures

Question 9

What genetic mutation is present with Ewing Sarcomas?

Answer 9

Fusion translocation: EWSR1-FL11

Question 10

What genetic mutation is present with Ewing Sarcomas?

Answer 10

Fusion translocation: EWSR1-FL11

Question 11

What is a good prognostic finding with Ewing Sarcomas?

Answer 11

Increased chemo-induced necrosis

== means the tumor is sensitive to treatment

Question 12

What is a good prognostic finding with Ewing Sarcomas?

Answer 12

Increased chemo-induced necrosis

Question 13

Giant Cell Tumor of the bone involves what cells?

Answer 13

Multinucleated OSTEOCLAST-type giant cells with 100+ nuclei

Question 14

Multinucleated osteoclast-type giant cells with 100+ nuclei is likely?

Answer 14

Giant cell tumor of bone

Question 15

In the DDX for Giant Cell Tumor of bone, what must be considered?

Answer 15

Brown tumor from hyperparathyroidism

Question 16

What are the symptoms with Giant Cell Tumor of bone?

Answer 16

Arthritis like symptoms

Question 17

How do Giant Cell Tumors of bone look on x-ray?

Answer 17

Bulging soft tissue mass with thin shell of reactive bone

Question 18

How do Giant Cell Tumors of bone look on x-ray?

Answer 18

Bulging soft tissue mass with thin shell of reactive bone

Question 19

Soft tissue mass with a thin shell of reactive bone with arthritis like symptoms?

Answer 19

Giant cell tumor of bone

Question 20

When do Aneurysmal Bone Cysts usually present and where?

Answer 20

Adolescence

– vertebral body, femur, tibia

Question 21

What are the symptoms of Aneurysmal Bone Cysts?

Answer 21

Pain, swelling –> limp and nerve compression

Question 22

What are the symptoms of Aneurysmal Bone Cysts?

Answer 22

Pain, swelling –> limp and nerve compressions

Question 23

Central lysis with “eggshell” of reactive bone at the periphery

Answer 23

Aneurysmal bone cyst

Question 24

How do Aneurysmal Bone Cysts look?

Answer 24

Central lysis with “eggshell” of reactive bone at periphery

Question 25

What can appear on imaging with Aneurysmal Bone Cysts?

Answer 25

Soap bubble

Question 26

Some cases of Aneurysmal Bone Cysts appear blue. Why?

Answer 26

Basophilic matrix

Question 27

This tumor usually presents in the vertebral body, femur or tibia in adolescence

Answer 27

Aneurysmal Bone Cyst