bone tumours Flashcards
-bone tumours can be — or — which can be — or — aka —
* Most common bone tumours in children and young adults are— bone tumours
* Most common bone tumour in older adults are — and — from other sites
bengin or malignant which can be primary or 2ndary aka metastasis
primary benign
multiple myeloma and metastasis
metastatic tumours to bone:
1- – much more common than –
– Carcinoma of the breast
– Prostatic carcinoma
– Bronchogenic carcinoma
– Renal cell carcinoma
2- Osteolytic
– — erosion of —
– Stimulation of – by —
3- Osteosclerotic ( — ) e.g. — carcinoma
carcinoma
sarcoma
direct
bone
osteoclast
cytokines
osteoblastic
prostatic
complications of metastatic tumours:
1- —
2- pathologic -
3- replacement of —
4- —
5- — and — compression
pain
fractures
bone marrow
hypercalcaemia
nerve and spinal
- Primary malignant proliferation of plasma cells in the marrow is known as –
- which can be — or –
myloma
Solitary plasmacytoma or multiple myeloma
*— tumours are more common in
children and young adult
* — tumours are more common in
older individuals
* Accurate diagnosis depend on– , — and – examination of the lesion
* Many tumours characteristically involve certain part of bone
- examples of primary bone marrow :
primary benign
primary malignant
clinical radiologic and pathologic
primary bone marrow examples:
* Bone-producing tumours
* Cartilage-producing tumours
* Other types
bone forming tumours:
1- Benign as:
– —
– —
2- Locally aggressive as:
– —
3- Malignant as:
– —
ostoema and osteoid-oestoma
osteoblastoma
osteosarcoma
1- osteoma:
* — forming tumour
* Often — in location
* Probably — or — growth and not true —
* Associated with — and —
2- osteoid osteoma:
* — forming tumour
* – age ( – decade)
* Male: female = —:–
* – due to presence of —-
levels
* Pain relived by —
* – size (< –cm)
* Cortex of – or –
* Nidus consists of – spaces surrounded by — bone
* Therapy - — of nidus
benign bone
carniofacial
hamartomatous
reactive
neoplasm
gardner sydnrom
multiple osteomas
benign bone
young
2nd
3:1
painful
high intra-lesional prostaglandin
aspirin
small
2
femur or tibia-Diaphysis
vascular
sclerotic bone
complete resection
osteoblastoma:
* – forming tumour
– Can be locally – (local recurrence)
* — age
* Most common location is –
* > – cm
* – or no— reaction
* Pain not relived by —
* Therapy- — / –
osteosarcoma:
* — forming tumour
* — age distribution
– Young - < – years
– Second peak in –
* Most arise in the — of a – bone, classically around the – ( – or –)
benign bone
local aggressive
young
vertebral
2 cm
minimal or no sclerotic
aspirin
curettage/resection
malignant bone
bimodal
<20
elderly
metaphysics
long bone
knee
distal femur or proximal tibia
Malignant bone forming tumour is known as —
1- risk factors:
– — predisposition ( – and — in – regulators including Rb, p16 and p53)
– — exposure
– – disease
2- clinical features:
* – and/or – of the affected region with or without a —
* Pathological —
* — metastasis (lung)
3- spread:
* Within the —
* Through the –
* Across — plate
* —
4- imaging:
– Destructive – with
– “ — ” appearance
– — ( — of the periosteum)
* Biopsy Pleomorphic cells that produce–
* Patients are usually treated with pre-operative – and — resection
* — prognosis- metastasis occur – in the course
* The current disease-free-five-year survival rate is about –
oseteosacroma
genetic
deletion or mutation in cell cycle regulators
radiation
pagets disease
tenderness and pain with or without palpable mass
fracture
distant
medullary cavity
periosteum
epiphyseal plate
haemotgenous
destructive mass
sunburst
condmans triangle
lifting
osteoid
chemo and surgical
poor
early
60%
cartilage producing tumors:
* —
– Osteochondroma
– Enchondroma
– Chondroblastoma
– Chondromyxoid fibroma
* —
– Chondrosarcoma
benign
malignant
Most common benign tumour is —
* Tumour of bone with an overlying —
* Age <– years
* — (osteochondromatosis-hereditary) or — (sporadic)
* —-shaped – projections from the – aspects of — bones
* Arise from —
* — can occasionally arise in osteochondromas; incidence is higher in osteochondromatosis
osteochondroma
overlying cartilage cap
20
multiple
single
mushroom
bony
lateral
long lines
metaphysis
Chondrosarcomas
enchodroma;
* — tumours of cartilage
»– age (— - – years)
* Arise in – of — bones of – and –
* — or — sites
– — disease (usually one side of the body)
– — syndrome – (heamangiomas of soft tissue)
– — risk for chondrosarcoma
*—-circumscribed — hyaline cartilage
benign
any
20-50
medulla
small bones
hands n feet
single or multiple
Ollie’s
maffucci
increased
well
mature
chondrosacroma:
* — tumour of cartilage
* – most common malignant tumor of bone
– Half as frequent as –
* – or from a previous – tumour
* – age > –
* — skeleton (bones of pelvis and shoulder girdles, ribs and
spine)
malignant
2nd
osteosarcoma
de novo or previos bengin tumour
middle >40
axial
in chondrosacroma:
Morphologically, these tumors are composed of — of – with chondrocytes in the — and with — ossification and –
* These tumors can be quite – and can erode through – bone to involve the —
* Can metastasise to – , – , – and –
* Chondrosarcomas are not sensitive to —- agents, and treatment is usually restricted to –
* – prognosis (— year survival rate –%)
lobules of cartilage w chondrocyte
lacunae
focal and calcification
aggressive
cortical bone
soft tissue
lungs liver kidney and brain
chemotherepatutic agents
surgical resection
poor
5
40%
1- osteosarcoma:
* — years of age and –
* Affects —
* Sensitive to –
2- chondosacroma:
* >— years of age
* Affects —
* Not sensitive to —
10-25 and elderly
long bones
chemo
>40
axial skeleton
chemo
giant cell tumours aka —- :
* Adults — - –
* — ends of — bones ( — ) ( —,— )
* – cells and — osteoclast-like giant cells
* — appearance on x-ray
* — aggressive tumour ( – recurrence if curetted – %)
* 4% are – and –
aka osteoclasteoma
20-55
epiphyseal
long bones ( knee) ( distal femur and proximal tibia)
stormal alls and multiucleated
soap bubble
locally
high
50%
Maligant and metasiseis
ewings sarcoma:
* — proliferation of – differentiated cells derived from –
* Age – and –
* Sites- – cavity in the – of – bones, – and –
* Chromosomal translocation t (—,–)
* Biopsy reveals — cells
* X ray- – skin
* – aggressive
* Treatment- —
* – + — has ↑ survival 5% » 75%
* Prognosis is very — :
<10% 5-year survival with – and –
40% with –
malignant
poorly
neuroendocrine
children n young adults
medullary sites in diaphysis of long bones pelvis and ribs
11:22
small round blue
onion
highly
chemo
chemo + surgery
very poor
surgery + radio
adjacent chemo
