Exam 1- Bone Tumors Flashcards
What is the most common type of bone tumor?
Metastasis to bone is MC
Who is at risk for Low back pain of cancerous origin
50 yrs old or more
History of cancer
Cache is (unexplained weight loss)
Pain longer than a month
What are the 3 MC primary bone cancers
- Osteosarcoma
- Chondrosarcoma
- Ewing sarcoma
Elderly= increased risk that bone tumor is malignant
Bone tumors normally occur when?
Before 40
Slow growing, long bones of extremities,
Age and location of osteosarcoma
10-20, knee
Age and location of osteoma
Age 40-50, facial bones/skull
Osteod Osteoma occurs to who and when
Males 2x more likely, age 10-20
Localized nocturnal pain
Smaller than 2 cm, near cortex of femur/tibia, relieved by aspirin
What is an osteoblastoma
2-6cm
Vertebral processes affected
Unrelieved by aspirin
What is an osteosarcoma
Bone producing sarcoma
MC primary bone CA
Males 1.5x more likely 75% of cases less than 20yrs old
Associated with a Codman triangle on X-ray
Location of osteosarcoma
Long bone metaphysics
Knee=60%. Hip= 15% Shoulder= 10%
Destroys cortex “sunburst”
A person that has retinoblastoma syndrome is 1000x higher risk of getting
Osteosarcoma
What is a primary Osteosarcoma
Age 10-20, 60-70% survival rate
Aka typical
Secondary Osteosarcoma
AKA co-morbid
Age 40 or over, paget disease poor response to therapy, typically fatal
Cartilage forming tumors
Hyaline= clear, glass like
Myxoid= mucus like
MC benign
3 main types of Cartilage forming tumors
Osteochondroma aka exostosis
Chondroma aka enchondroma
Chondrosarcoma
Osteochondroma
Benign, cartilage capped outgrowth
Hyalin cartilage
Males 3x higher risk age 10-30
What are the two forms of osteochondroma
Solitary- sporadic, adolescent/ young adult onset
Multiple hereditary Osteochondromas- familial, mutated TSG, childhood onset
Where do osteochondromas occur?
Knee (MC), pelvis, scapula, ribs
1-20cm, slow growing
What’s a chondroma
Benign tumor of hyaline cartilage
Naming is location based
Aka Enchondroma= medullary (favored)
Age of onset of chondroma
20-50
What is Oliver disease
Multiple enchondromas, result of sporadic mutations
MC spot for solitary enchondromsas
Inn the hand specifically proximal phalanges
Gray-blue nodules of hyaline cartilage is a symptom of
Chondroma
Also can have a o-ring
Chondrosarcoma is the 2 MC
Primary bone cancer
40-60 years old males 2x more likely
Chondrosarcoma occur
In pelvis shoulder ribs, prox femur. Intermedullary MC
The mass has a “glistening” appearance
It expands within the cavity eroding cortex
Difference between low and high grade chondrosarcoma
Low grade- MC, slow growing, favorable prognosis
High grade- cortical erosion, large soft tissue mass, 70% mets: lungs is MC, only 40% survival
What is a fibrous cortical defect
Benign tumor of fibroblasts + macrophages, normally tiny
If larger than 3 cm, its a Nonossifying fibroma
Normally occurs at knee
What causes Fibrous Dysplasia
Spontaneous GNAS mutation
Monostotic- single bone is involved
Polyostotic- multiple bones are involved
Polyostotic- endocrinopathy aka MCCune Albright syndrome
What is MC fibrous dysplasia
Monostotic 10-30 yrs old
Polyostotic 27% of cases, severe deformation late childhood
Ewing sarcoma is
Femur diaphysis painful enlarging mass
“Onion skinning”
Caucasians 9x more likely and males. 75% survival after 5 yrs
Giant cell tumor of bone is
Multinucleated giant cells
MC at knee, erodes cortex age 20-40
Diagnosis biopsy
Arthritis like pain
Thin “shell” of cortex, “soap bubble” appearance
Most common metastasis to bone
Adults- prostate (blastic), breast (lytic), lung (mixed)
Children- neuroblastoma, Wilms tumor, Osteosarcoma, rhabdomyosarcoma, ewing sarcoma
