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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
Q

Where does an osteosarcoma tend to metastasize?

A

LUNGS, other bones and brain

26
Q

What are the genetic diseases associated with osteosarcoma?

A
  1. Hereditary Retinoblastoma

2. Li-Fraumeni Syndrome

27
Q

A bone producing tumor in the metaphysis of the knee of a teenager is most likely what?

A

Osteosarcoma

28
Q

What cancer is linked to multiple hereditary exostosis, with a mutation in EXT1 or EXT2?

A

Osteochondroma

29
Q

What will be seen on the X-ray of an osteochondroma?

A

A mushroom shaped cartilage capped mass growing away from the epiphysis

30
Q

What is classified as a benign hyaline cartilage tumor? And what are the two types?

A

Chodroma

Enchondroma (medullary cavity) and subperiosteal chondroma (Juxtacortical chondroma at the surface of the bone)

31
Q

What age group do you see chondromas?

A

20-50

32
Q

What cancer is described as a grey-blue nodule(s) of hyaline cartilage less than 3cm in diameter with peripheral enchondral ossification?

A

Enchondroma

33
Q

Enchondromas are likely to transform into sarcomas in what two cases?

A
  1. Enchondromatosis (Ollier Disease)

2. Maffucci Syndrome (Enchondroma with Hemangiomas)

34
Q

What is the most common tumor of the phalanx?

A

Enchondroma

35
Q

A rare cancer in the knee epiphyses of teenagers is most likely to be what?

A

Chondroblastoma

36
Q

Chondrosarcomas are most likely to occur where? What is the exception?

A

Central Skeleton- Pelvis, shoulder and ribs

Exception- Clear Cell- long bone epiphyses

37
Q

Multiple enchondromas or osteochondroma increase the risk for what?

A

Chondrosarcoma

38
Q

What cancer has an X-ray showing nodular growth with endosteal scalloping and flocculent densities from calcification with reactive thickened cortex?

A

Chondrosarcoma

39
Q

What age group is most commonly affected with chondrosarcomas? What are the exceptions?

A

> 40

Exceptions- Clear Cell Chondrosarcoma and Mesenchymal Chondrosarcoma affect teens/young adults

40
Q

A grey-yellow-brown tissue composed of fibroblasts and histiocytes can be what two conditions? Which is larger?

A

Fibrous Cortical Defect or Nonossifying Fibroma

-Nonossifying Fibromas can be 6cm

41
Q

What fibrous dysplasia is associated with endocrine dysfunction?

A

McCune-Albright Syndroma (Polyostotis)

42
Q

How does fibrous dysplasia appear on X-ray? Where does it occur?

A
  • Ground glass appearance with well-demarcated border

- Metaphysis or diaphysis

43
Q

When do fibrous dysplasias stop growing?

A

With closure of the growth plates

44
Q

Where do monostotic fibrous dysplasias commonly occur?

A

Ribs, femur, tibia, jaws, calvaria and humerus

45
Q

What are the two types of polyostotit fibrous dysplasias?

A
  1. Mazabraud Syndrome (soft tissue myxomas)

2. McCune-Albright Syndrome

46
Q

What condition is associated with café au lait skin pigmentations, sexual precocity, hyperthyroidism, pituitary adenomas, adrenal hyperplasia and hyper reactive G-protein of GNAS?

A

McCune-Albright Syndrome (Fibrous Dysplasia)

47
Q

What condition presents with microscopic “Chinese Character” woven bone in the fibrous stroma?

A

Fibrous Dysplasia

48
Q

What cancer is a small blue cell tumor of bone and soft tissue with excess glycogen and Homer-Wright rosettes?

A

Ewing Sarcoma (PNET if less differentiated)

49
Q

What is the translocation associated with Ewing’s Sarcoma?

A

t(11,22) EWS-FLI1

50
Q

Where do Ewing Sarcomas occur?

A

Diaphysis of long bones; originate in medullary cavity but invade cortex into soft tissue to create mass

51
Q

Describe the X-ray of a Ewing Sarcoma

A

Lytic destruction with onionskin periosteal reaction and SUNBURST pattern

52
Q

What is a Giant Cell Tumor of the bone?

A

Benign tumor of macrophage/monocyte system originating in the epiphysis that may extend into the metaphysis

53
Q

Where are most Giant Cell Tumors?

A

Knee

54
Q

What cancer is associated with mononuclear expression of RANKL, hemorrhage, reactive bone and hemosiderin?

A

Giant Cell Tumor

55
Q

Describe the X-ray of a Giant Cell Tumor

A

Lytic, eroding into subchoroidal bone plate, erodes cortex into soft tissue with a thin shell of covering bone

56
Q

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?

A

Aneurysmal Bone Cyst

57
Q

In what cancer will you see internal fluid levels between septa?

A

Aneurysmal Bone Cyst

58
Q

What is the most common form of skeletal malignancy?

A

Metastatic Disease

59
Q

How does METs spread through the spine?

A

In Batson Plexus

60
Q

Where is the source of bone metastasis in METs?

A

Breast, Lung, Thyroid, Kidney, Prostate

61
Q

What are the causes of METs in Pediatric patients?

A
  1. Neuroblastoma
  2. Osteosarcoma
  3. Wilms Tumor
  4. Ewing Sarcoma
  5. Rhabdomyosarcoma

Disease and Therapeutics 1 (7 decks)

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