Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Block 4: Musculoskeletal > Bone Tumors (Week 3--Nelson) > Flashcards

Bone Tumors (Week 3--Nelson) Flashcards

1
Q

Bone tumors

A

Rare

They are mesenchymal tumors and mesenchymal tumors don’t follow the normal dysplasia –> carcinoma in situ –> carcinoma pattern

Must have clinical and radiological correlation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Primary bone tumor

A

Primary bone tumor (start in the bone) that is malignant is called a sarcoma

This is NOT cancer that has metastasized (ie breast cancer metastatic to bone is NOT bone cancer!)

Also, this is NOT bone marrow/hematopoietic cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Malignant bone tumors

A

De novo malignant tumor (don’t know what caused it)

From benign to malignant

Secondary from radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Malignant primary bone tumors

A

Very rare (<.01% of malignancies)

Aggressive

Hematogenous spread of sarcomas (conversely, remember carcinomas go through lymphatics)

Correct diagnosis depends on clinical history, radiographic studies, histology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Osteosarcoma

A

“The mother of all bone tumors”

Most common primary malignant bone tumor

Two peaks: 10-20 (KIDS) and 60-70

Pain and swelling

Different types and grades of osteosarcoma

Pathogenesis not understood in most cases

Known to follow radiation, Paget’s disease

Most common in long bones, metaphysis (KNEE) (but can also be in other places like craniofacial, small bones, extraskeletal (soft tissue))

Aggressive, fatal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Osteosarcoma on radiology

A

Malignant appearance

Infiltrative, destructive

Blastic, mineralized

Codman’s triangle, sunburst pattern (STEP 1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Osteosarcoma gross pathology

A

Filling medullary portion, breaking through cortex, extending into soft tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Osteosarcoma histology

A

Plump neoplastic osteblasts

Delicate, immature osteoid production (these tumors make bone)

Infiltration and destruction of normal bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Variants of osteosarcoma

A

Not important what they are!

Osteoblastic

Chondroblastic

Telangiectatic

Small cell

Low grade intramedullary

Periosteal

Parosteal

Fibroblastic

Dedifferentiated

Giant cell rich

Chondroblastoma-like

Osteoblastoma-like

Intracortical low-grade

Etc…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When does it not matter what specific variant the osteosarcoma is?

A

When the osteosarcoma is high grade, it doesn’t matter what the specific variant is

Most ARE high grade!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where can osteosarcoma spread to?

A

Lungs, just like many other sarcomas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Osteosarcoma treatment and prognosis

A

Treatment: chemotherapy (at least 3 types, high grade), excision, rarely do amputations anymore

Prognosis: 60-75% 5 year survival (much improved)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Chondrosarcoma

A

Second most common primary bone tumor (after osteosarcoma)

Chondro = cartilage

Adults age 40-60

Pelvis, flat bones, only sometimes in long bones

Usually de novo

Can be from osteochondroma

Most are grade I (low grade), but can be grade II or III

Low grade may “dedifferentiate” into high grade sarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Chondrosarcoma on radiology

A

Lobulated

Destructive mass with calcification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Chondrosarcoma gross pathology

A

Lobulated

Destructive

White/translucent

Calcified

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chondrosarcoma histology

A

Lobules of cartilage

Permeating bone (invasive)

Calcification

17
Q

Chondrosarcoma treatment

A

Excision

Generally NOT chemotherapy sensitive

18
Q

Ewing Sarcoma/PNET

A

A member of the Primitive Neuroectodermal Tumor (PNET) family

11:22 translocation

Usually in children

Diaphyseal (long tubular part of the bone)

Present as pain, mass

May be very rapidly growing

19
Q

Ewing sarcoma/PNET on radiology

A

Lucent lesion with reactive bone formation, edema

Looks much like osteomyelitis, LCG

Spiculated?

20
Q

Ewing sarcoma/PNET histology

A

Malignant small blue round cells

High mitotic rate

Geographic necrosis

Special tests help: cytogenetics, IHC

21
Q

Ewing sarcoma/PNET treatment and prognosis

A

Chemotherapy

Radiation therapy

Surgical excision

Prognosis: improving, to 60%

22
Q

Chordoma

A

Adult tumor

Usually in sacrum, spine

Presents as a mass with bone destruction

Thought to be from notochord remnants

Malignant

23
Q

Chordoma on radiology

A

Expansile lesion

Destroying bone and extending into soft tissue

24
Q

Chordoma gross pathology

A

Lobulated

Myxoid

25
Q

Chordoma histology

A

Cords of cells in loose myxoid matrix

Bubbly “physaliphorous” cells

26
Q

Chordoma treatment and prognosis

A

Treatment: excision

Prognosis: high recurrance rate, intermediate metastatic potential

27
Q

Transformation

A

Benign primary bone tumors transform to malignant forms

28
Q

Fibrous dysplasia

A

Benign expansile bone tumor

Long bones, facial bones

Can transform to osetosarcoma (bad!)

29
Q

Osteochondroma transformation to secondary chondrosarcoma

A

Osteochondroma is benign

But 10% chance of malignant change to chondrosarcoma

30
Q

Giant cell tumor

A

Benign

Epiphyseal tumor of adults (skeletally mature)

Need to rule out hyperparathyroidism, which causes identical “brown tumor”

31
Q

Giant cell tumor on radiology

A

Lucent, destructive mass in epiphysis

32
Q

Giant cell tumor treatment and prognosis

A

Treatment: curettage, excision

Prognosis: 20% recurrance rate, but only rarely malignant transformation

33
Q

Malignant giant cell tumor

A

Rare transformation to malignancy

Turns to high grade sarcoma

Most common following radiation therapy for benign giant cell tumor

May occur de novo

34
Q

Plasmacytoma

A

Tumor of malignant plasma cells

If there are multiple, then multiple myeloma

Monoclonal immunoglobulin spike in SEP

Atypical plasma cells

35
Q

Plasmacytoma on radiology

A

Punched out lesions

Lytic

36
Q

Cancers that metastasize to bone

A

Breast

Renal

Thyroid

Prostate

Most common “bone” tumor

Treatment is curettage, fixation (hardware)

Often present with pain or pathologic fracture

37
Q

Clinical information important in diagnosing bone tumors

A

Age

Presentation (time period)

Radiographic

Location (epiphysis, metaphysis, diaphysis, etc)

38
Q

Where do we look for metastasis of bone cancer?

A

Metastasize from leg bones to lungs, so look in lungs

39
Q

Why would osteosarcoma be mistaken for a reactive process?

A

Because both processes are laying down immature bone

Block 4: Musculoskeletal (37 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions