Bone Tumours Flashcards
What disease are osteomas associated with?
Gardner syndrome =
Familial adenomatous polyposis
Fibromatosis @ peritoneum = non-neoplastic proliferation of fibroblasts that destroys tissue
Osteoma of facial bones
Is in osteoma benign?
Where do you find osteomas?
Benign bone tumour
@Surface of facial bones
What is in osteoid osteoma
Benign tumour of osteoblasts
The tumour produces osteoid – >
get rim of sclerotic reactive bone around it
Epidemiology of osteoid osteoma?
Young adults <25 years
What type of bone does osteoid osteoma effect?
Where specifically on the bone does osteoid osteoma occur?
Long bone cortex
Diaphyses
What does osteoid osteoma bone pain resolved with?
Aspirin
How does osteoid osteoma present on imaging?
Radiolucent core = osteoid
+
Bony mass = osteoma
Give three differences between osteoblastoma and osteoid osteoma
Osteoblastoma:
>2 cm
@Vertebrae
Bone pain = not respond to aspirin
Osteoid osteoma:
<2 cm
@Cortex of deficits of long bones
Bone pain respond to aspirin
What is the most common benign bone tumour?
Osteochondroma
What is an osteochondroma
Benign bone tumour with overlying cartilage
Where does the osteochondroma arise from?
Arises from lateral projection of growth plate
What is the bone continuous with in osteochondroma?
Marrow space
What is an osteosarcoma
Malignant tumour of bone
specifically malignant proliferation of osteoblasts
Incidence of osteosarcoma
@Teens >elderly
What are the four risk factors for osteosarcoma
Familia retinoblastoma = hence @ teenagers
Radiation +
Pagett disease of bone
Li-Fraumeni syndrome – P 53 germline mutations
Explain how a patient with osteosarcoma would present
Pathologic fracture: tumour weaken bone – >fracture
+
Bone pain + swelling
Explain where on the body does osteosarcoma usually occur?
Distal femur + proximal tibia = KNEE
What does x-ray reveal for osteosarcoma
Osteoma grows+expands bone= codman triangle –>
drag periosteoma of bone into adjacent software – >
sunburst appearance
What comprises a giant cell tumour?
Multinucleated giant cells
+
Stromal cells
Where does it giant cell tumour occur on the bone?
Epiphysis of long bones – the only epiphyseal tumour
Knee = distal femur/proximal tibia
What does x-ray reveal for giant cell tumour
Soap bubble
Tumour – > reactive bone in response to tumour – > soap bubbles @ epiphysis
What does biopsy of osteosarcoma reveal?
Pleomorphic cells that make osteoid
Where exactly on the bone does Ewings sarcoma okay?
What type of bone? Who does it affect?
At diathesis inside medullary cavity
Long bones
Male kids < 15 years
What is Ewing sarcoma
Malignant proliferation of poorly differentiated cells derived from neuroectoderm
Explain how Ewing sarcoma grows?
Grow inside medullary cavity – >
Push on bone surface – >
layering of new bone by periosteum= Onionskin appearance @ x-ray
What would biopsy and histology reveals for Ewing sarcoma
Small round blue ANAplastic cells
At histology what can Ewing sarcoma be confused with
Lymphoma + chronic osteomyelitis
Osteomyelitis also presents with fever and bone swelling so can be confused with Ewing sarcoma too
How do you distinguish lymphoma +osteomyelitis from Ewing sarcoma
11:22 translocation causing
fusion protein EWS – FLI 1
How aggressive it is Ewing sarcoma?
How do you treat it?
Chemo
Two types of cartilage tumours?
Where do they arise in the bone?
Chondroma – benign = @small bones of hands + feet
Chondrosarcoma – malignant =
@Centrally occurring – pelvis + central skeleton
in the medulla
Which bone tumours are more common metastatic or primary?
Metastatic > primary
How do metastatic bone tumours present?
Osteolytic/punched out lesions of the bone
Give an exception for a metastatic tumour related to bone that isn’t punched out?
Prostate cancer – osteoblastic lesion
No punched out circular space
Activation of osteoblast – >
lays down bone next to -> get sclerosis
What is a Lipoma?
Benign tumour of adipose tissue
What is the most common benign soft tumour tissue in adults
Lipoma
At histology we see LIPOblasts. what is the diagnosis?
Liposarcomas – malignant tumour of adipose tissue
What is the most common malignant soft tissue tumour in adults
Liposarcomas
What is the rhabdomyoma?
What is the cardiac rhabdomyoma associated with?
Benign tumour of skeletal muscle
Associated with tuberous sclerosis and St heart and tongue
What is the most common malignant soft tumour @kids
Rhabdomyosarcoma - malignant tumour of skeletal muscle
What is the characteristic cell for rhabdomyosarcoma
The rhabdomyoblast = desmin positive
Where does rhabdomyosarcoma okay?
@Head + neck
@ a young girl – five years = vagina
A young girl presents with a grape-like mass protruding from the vagina. Biopsy = rhabdomyoblast is Desmin positive with striation within the cells.
sarcoma praeities – Embryonal rhabdomyosarcoma
What is the fibrosarcoma and where is it
Arise after irradiation
Thigh upper limb
What is a dermatofibromas
But 99 in capsulated proliferation of spindle cells confined to dermis
Read nodule that umbilicate (i.e. has a central dimple) when squeezed
What is a malignant fibrous histiocytoma and where is it
Radiation therapy + scarring
Retroperitoneum thigh
What is a leiomyoma and leiomyosarcoma where does it occur
Uterus + GI tract for both
What is a synovial sarcoma and where does it occur
Doesn’t arise from Synovial cells in joints
Arise from mesenchymal cells around joints
Has biphasic pattern: epithelial cells forming glands + intervening spindle cells
