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Disease and Therapeutics 1 > Bones 2 > Flashcards

Bones 2 Flashcards

1
Q

What is the most common primary bone tumor?

A

Hematopoietic Tumor

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2
Q

What are the two types of matrix producing bone tumors?

A

Chondrogenic and Osteogenic

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3
Q

Most bone tumors are…

A

Benign

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4
Q

What is the most common benign tumor?

A

Osteochondroma/Fibrous Cortical Defect

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5
Q

What is the most common malignant tumor?

A

Osteosarcoma (Chondrosarcoma and Ewings)

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6
Q

Bone tumors in children and young are most likely…

Bone tumors in adults are most likely…

A

Benign

Malignant

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7
Q

What are two common genetic associations of bone tumors

A

Li Fraumeni Syndrome (p53)

Retinoblastome (Rb)

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8
Q

What are 4 other features associated with bone tumors?

A

Paget Disease, Metal Prosthesis, Chronic Osteomyelitis and Infarcts

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9
Q

What are the two bone cancers that present at the Epiphysis?

A
  1. Clear Cell Chondrosarcoma

2. Chondroblastoma

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10
Q

What are the two bone cancers that present at the diaphysis?

A
  1. Ewing Sarcoma

2. Fibrous Dysplasia

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11
Q

What are the two bone cancers that can present at the Epiphysis/Metaphysis?

A
  1. Giant Cell Tumor

2. Aneurysmal Bone Cyst

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12
Q

What cancer is associated with bone formation (woven and lamellar) in the sinuses, skull and face?

A

Osteoma

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13
Q

Osteomas are typically incidental, unless what?

A

They impinge on the brain or obstruct a sinus

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14
Q

What is Gardner Syndrome and what cancer is it associated with?

A

A syndrome involving intestinal polyps, epidermal cysts and fibromatosis; associated with multiple osteomas

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15
Q

Where are osteoid osteomas typically found; how big are they; describe the pain; and do NSAIDs help?

A

Metaphysis cortex
Less then 2cm
Intense Pain at Night
Yes, NSAIDs help

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16
Q

Where are osteoblastoms typically found; how big are they; describe the pain; and do NSAIDs help?

A

Vertebrae Posterior
Greater than 2cm
Dull Ache
No, NSAIDs do not help

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17
Q

What bone cancer can be seen radiographically as a round central lucent (dark area) surrounded by sclerotic bone?

A

Osteoid Osteoma

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18
Q

What bone cancer can be seen as a radiolucent mass on the posterior vertebra?

A

Osteoblastoma

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19
Q

What cancer is bimodal in age distribution, affecting 20 year olds (knee) and elderly (flat and long bones)?

A

Osteosarcoma

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20
Q

What cancer may present with a painful enlarging mass?

A

Osteosarcoma

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21
Q

What part of the bone does osteosarcoma typically affect?

A

Metaphysis

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22
Q

What bone cancer is poorly differentiated with a bony matrix, has hemorrhage and necrosis and destroys adjacent bone and soft tissue?

A

Osteosarcoma

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23
Q

Does an osteosarcome tend to breach the epiphyseal plate or joint?

A

No

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24
Q

What are the distinguishing features of an Osteosarcoma on X-ray?

A
  1. Codman Triangle (tumor lifts periosteum)

2. Destructive with mixed lytic and blastic

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25
Where does an osteosarcoma tend to metastasize?
LUNGS, other bones and brain
26
What are the genetic diseases associated with osteosarcoma?
1. Hereditary Retinoblastoma | 2. Li-Fraumeni Syndrome
27
A bone producing tumor in the metaphysis of the knee of a teenager is most likely what?
Osteosarcoma
28
What cancer is linked to multiple hereditary exostosis, with a mutation in EXT1 or EXT2?
Osteochondroma
29
What will be seen on the X-ray of an osteochondroma?
A mushroom shaped cartilage capped mass growing away from the epiphysis
30
What is classified as a benign hyaline cartilage tumor? And what are the two types?
Chodroma Enchondroma (medullary cavity) and subperiosteal chondroma (Juxtacortical chondroma at the surface of the bone)
31
What age group do you see chondromas?
20-50
32
What cancer is described as a grey-blue nodule(s) of hyaline cartilage less than 3cm in diameter with peripheral enchondral ossification?
Enchondroma
33
Enchondromas are likely to transform into sarcomas in what two cases?
1. Enchondromatosis (Ollier Disease) | 2. Maffucci Syndrome (Enchondroma with Hemangiomas)
34
What is the most common tumor of the phalanx?
Enchondroma
35
A rare cancer in the knee epiphyses of teenagers is most likely to be what?
Chondroblastoma
36
Chondrosarcomas are most likely to occur where? What is the exception?
Central Skeleton- Pelvis, shoulder and ribs Exception- Clear Cell- long bone epiphyses
37
Multiple enchondromas or osteochondroma increase the risk for what?
Chondrosarcoma
38
What cancer has an X-ray showing nodular growth with endosteal scalloping and flocculent densities from calcification with reactive thickened cortex?
Chondrosarcoma
39
What age group is most commonly affected with chondrosarcomas? What are the exceptions?
>40 | Exceptions- Clear Cell Chondrosarcoma and Mesenchymal Chondrosarcoma affect teens/young adults
40
A grey-yellow-brown tissue composed of fibroblasts and histiocytes can be what two conditions? Which is larger?
Fibrous Cortical Defect or Nonossifying Fibroma -Nonossifying Fibromas can be 6cm
41
What fibrous dysplasia is associated with endocrine dysfunction?
McCune-Albright Syndroma (Polyostotis)
42
How does fibrous dysplasia appear on X-ray? Where does it occur?
- Ground glass appearance with well-demarcated border | - Metaphysis or diaphysis
43
When do fibrous dysplasias stop growing?
With closure of the growth plates
44
Where do monostotic fibrous dysplasias commonly occur?
Ribs, femur, tibia, jaws, calvaria and humerus
45
What are the two types of polyostotit fibrous dysplasias?
1. Mazabraud Syndrome (soft tissue myxomas) | 2. McCune-Albright Syndrome
46
What condition is associated with café au lait skin pigmentations, sexual precocity, hyperthyroidism, pituitary adenomas, adrenal hyperplasia and hyper reactive G-protein of GNAS?
McCune-Albright Syndrome (Fibrous Dysplasia)
47
What condition presents with microscopic "Chinese Character" woven bone in the fibrous stroma?
Fibrous Dysplasia
48
What cancer is a small blue cell tumor of bone and soft tissue with excess glycogen and Homer-Wright rosettes?
Ewing Sarcoma (PNET if less differentiated)
49
What is the translocation associated with Ewing's Sarcoma?
t(11,22) EWS-FLI1
50
Where do Ewing Sarcomas occur?
Diaphysis of long bones; originate in medullary cavity but invade cortex into soft tissue to create mass
51
Describe the X-ray of a Ewing Sarcoma
Lytic destruction with onionskin periosteal reaction and SUNBURST pattern
52
What is a Giant Cell Tumor of the bone?
Benign tumor of macrophage/monocyte system originating in the epiphysis that may extend into the metaphysis
53
Where are most Giant Cell Tumors?
Knee
54
What cancer is associated with mononuclear expression of RANKL, hemorrhage, reactive bone and hemosiderin?
Giant Cell Tumor
55
Describe the X-ray of a Giant Cell Tumor
Lytic, eroding into subchoroidal bone plate, erodes cortex into soft tissue with a thin shell of covering bone
56
What cancer can be described as multi located blood filled cysts that rapidly grow in the metaphysis of long bones and vertebrae that cause pain and swelling?
Aneurysmal Bone Cyst
57
In what cancer will you see internal fluid levels between septa?
Aneurysmal Bone Cyst
58
What is the most common form of skeletal malignancy?
Metastatic Disease
59
How does METs spread through the spine?
In Batson Plexus
60
Where is the source of bone metastasis in METs?
Breast, Lung, Thyroid, Kidney, Prostate
61
What are the causes of METs in Pediatric patients?
1. Neuroblastoma 2. Osteosarcoma 3. Wilms Tumor 4. Ewing Sarcoma 5. Rhabdomyosarcoma

Disease and Therapeutics 1 (7 decks)

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