E2L21-22, Bone Tumors Pathoma

Question 1

Describe Gardner Syndrome

Answer 1

Condition involving: Familial Adenopolyposis, fibromatosis, facial osteomas

Question 2

What benign tumor arises on the surface of facial bones?

Answer 2

Osteoma

Question 3

What benign tumor appears in young adults, in the diaphysis cortex of long bones, and the assoc. pain resolves with aspirin?

Answer 3

Osteoid osteoma

Question 4

What does an osteoid osteoma look like on a radiograph?

Answer 4

Radiolucent mass surrounded by a rim of reactive bone

Question 5

What differentiates an osteoblastoma from an osteoid osteoma?

Answer 5

Osteoblastoma is: larger (over 2cm), found in vertebrae, pain doesn’t respond to aspirin

Question 6

Patient presents with benign tumor in vertebrae and pain doesn’t resolve with aspirin. Diagnosis?

Answer 6

Osteoblastoma

Question 7

Describe the most common benign tumor of bone

Answer 7

Osteochondroma

This is a lateral projection of growth plate causing a tumor of bone that is capped by cartilage

Question 8

What is a potential complication of osteochondroma?

Answer 8

Transformation into a malignant tumor called chondrosarcoma

Question 9

What bone tumor has a peak incidence in teens and the elderly and what risk factors are present for each age group?

Answer 9

Osteosarcoma
Teens: familial retinoblastoma
Elderly: Paget’s of bone, radtiation

Question 10

Where do osteosarcomas tend to develop in the body and what are some radiographic findings?

Answer 10

Metaphysis of long bones-generally around the knee
Radiograph: Codman’s triangle= periosteum being pulled off the bone as the tumor protrudes out of the bone creates a triangle of new bone growth

Question 11

Patient fractures humerus and on x-ray a tumor is found and Codman’s triangle is seen. Diagnosis?

Answer 11

Osteosarcoma

Question 12

Characteristics of an osteosarcoma

Answer 12

Peak incidence teens and elderly
Malignant
Metaphysis of long bones
Codman’s triangle

Question 13

What is the only bone tumor to present in the epiphysis?

Answer 13

Giant cell tumor

Question 14

Young adult presents with tumor around the knee. Radiograph shows soap-bubble looking bone in the epiphysis. Diagnosis?

Answer 14

Giant cell tumor

Question 15

Characteristics of Giant cell tumor

Answer 15

Made of multinucleated giant cells and stromal cells
Young adults, epiphysis, soap bubble appearance, locally aggressive
Knee area

Question 16

Tumor derived from neuroectoderm

Answer 16

Ewing sarcoma

Question 17

Young male patient has tumor in diaphysis of long bone that has onion-skin appearance on x-ray. Diagnosis?

Answer 17

Ewing sarcoma

Question 18

Describe the features of a Ewing Sarcoma

Answer 18

Malignant proliferation of poorly differentiated neuroectoderm cells
Diaphysis (medulla) of long bones of male kids
Onion-skin appearance on x-ray

Question 19

What other diseases is Ewing Sarcoma often confused with and why and how can they be differentiated?

Answer 19

On histo, Ewing has small round blue cells that resemble lymphocytes. Often confused with osteomyelitis and lymphoma
Differentiate by 11:22 translocation in ES cells

Question 20

Where do cartilage bones usually form?

Answer 20

In the medulla of the bone
Benign tumors are found in the small bones of the hands and feet
Malignant tumors are found in the central skeleton

Question 21

Patient has a tumor in the metacarpals, what is it likely to be?

Answer 21

Chondroma

Benign tumor of cartilage often found in the hands and feet

Question 22

Malignant tumor of cartilage found in the pelvis

Answer 22

Chondrosarcoma

Often found in the central skeleton but still in the medulla of the bone

Question 23

How do most metastatic bone lesions look and what is a notable exception?

Answer 23

Bone metastases are more common than primary bone tumors
Usually look like punched out lesions (osteolytic lesions)
Exception is prostate cancer metz as these produce osteoblastic lesions where bone is laid down at the site of metz