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ORAL PATHOLOGY! > Exam 6-Neoplasms of Bone-Malignant > Flashcards

Exam 6-Neoplasms of Bone-Malignant Flashcards

1
Q

What is the malignant bone neoplasm that originates from the bone?

A

osteosarcoma

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2
Q

What is the malignant bone neoplasm that originates from the cartilagenous tissue?

A

ChondroSarcoma

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3
Q

What are the 2 malignant bone neoplasms that originate from the bone marrow?

A

1.Ewing’s Sarcoma 2.Multiple Myeloma

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4
Q

An osteosarcoma: A malignant neoplasm of __________ cells

A

osteoblastic

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5
Q

An osteosarcoma: Produces osteoid matrix that may or may not ______

A

calcify

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6
Q

What is a malignant neoplasm of osteoblastic cells?

A

osteoSarcoma

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7
Q

These are all precursors of what malignantcy? Conventional, parosteal and Periosteal, extraskeletal,post radiation, in Pagets disease…

A

osteoSarcoma

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8
Q

In osteosarcoma entirely radiolucent lesions are simply matrix production without matrix _________

A

calcification

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9
Q

In osteosarcoma with mixed lucent-opaque lesions you just have variable degrees of matrix _________

A

calcification

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10
Q

IN osteosarcoma with densly opaque lesions it is simply a manifestation of an EXTENSIVE matrix ________

A

calcification

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11
Q

What is the MOST COMMON primary malignancy of BONE?

A

osteosarcoma

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12
Q

What % of osteosarcoma’s occur in the jaws?

A

7%

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13
Q

Osteosarcoma has a wide ____ range and WHICH sex is slightly more often affected?

A

age….males

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14
Q

Which arch is favored for the presence of osteosarcoma?

A

TRICKED YA! they are about equal in frequency

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15
Q

Osteosarcoma is usually symptomatic with Swelling and pain, _______ of adjacent teeth, and paresthesia/anesthesia

A

loosening

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16
Q

Radiographic features of osteosarc: Ill defined lesion; _____ into surrounding bone

A

BLENDS

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17
Q

What is the most emphasized worrisome radiographic feature of osteosarcoma (he repeated like 50x!!)? WHY is it so important to catch??

A

Symmetrical widening of the PDL space….May be the earliest change before the lesion is otherwise evident

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18
Q

Radiographic features of Osteosarcoma: Alveolar bone production _____ the level of the normal alveolar crest

A

ABOVE

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19
Q

Radiographic features of Osteosarcoma: Irregular root resorption or a “______” root form associated with an
irregular _______

A

“spiked”…lucency

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20
Q

The characteristic SUN-RAY/sunburst appearance is seen in WHAT PERCENT of osteosarcoma?

A

25%

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21
Q

Which characteristic of osteosarcoma is seen in 25% of them?

A

sun-burst

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22
Q

Which view of radiograph best shows osteosarcoma?

A

occlusal

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23
Q

What is the name of an osteosarcoma arising on the cortical surface rather than in an intramedullary location?

A

Juxta-Cortial Osteosarcoma

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24
Q

Which direction does a juxtacortical osteosarcoma INITALLY grow?

A

Initial growth is outward

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25
Q

Which form of osteosarcoma has a better prognosis-osteosarcoma or juxtacortical osteosarcoma?

A

jusxtacortical osteosarcoma generally has a better prognosis overall

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26
Q

What are the two subtypes of juxtacortical osteosarcoma?

A

Par-osteal and Peri-osteal

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27
Q

What is the MAINSTAY of treatment for osteosarcoma? BUT what is a problem?

A

RADICAL ablative surgery…local recurrence is a major problem

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28
Q

For osteosarcoma: PREoperative __________ has improved prognosis in some studies

A

chemotherapy

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29
Q

In osteosarcoma: _____ lesions metastasize less frequently than long bone disease Overall survival between 30-80%

A

JAW

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30
Q

What is the OVERALL survival rate for osteosarcoma?

A

between 30-80%

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31
Q

What is the malignant bone neoplasm producing cartilage but not bone?

A

A ChondroSarcoma

32
Q

A Chondrosarcoma: Cartilage matrix may show dystrophic ________ or maturation to bone…Radiographic lesions may be lucent, mixed, or opaque

A

calcification

33
Q

ChondroSarcoma: A malignant bone neoplasm producing ________ but NOT _____

A

cartilage…NOT bone

34
Q

What does a chondrosarcoma appear as? Radiolucent, Mixed? Radiopaque?

A

Yes. all.

35
Q

ChondroSarcoma is a relatively _______ lesion in the jaws

A

UNUSUAL

36
Q

In a ChondroSarcoma, ______ cartilage is largely ABSENT in the jaws

A

NORMAL

37
Q

A chondroSarcoma can be a ________ remnant in the anterior maxilla

A

vestigial

38
Q

Which unique area of the jaws is susceptible to ChondroSarcoma?

A

Condyles

39
Q

Although there is a wide age range for ChondroSarcoma, what age group is it most found?

A

most people over 50…ESPECIALLY in 6-7th decades

40
Q

Which sex is slightly more affected by ChondroSarcoma?

A

Males

41
Q

Clincial signs of ChondroSarcoma: Swelling or non-expansie?

A

swelling

42
Q

Clincial signs of ChondroSarcoma: Usually non-_____ but possible ________/anesthesia

A

non-painful…paresthesia

43
Q

Clincial signs of ChondroSarcoma: What happens to adjacent teeth?

A

loosening

44
Q

Which arch is favored in chondrosarcoma?

A

maxillary

45
Q

Radiographic Features of ChondroSarcoma: how is it defined? is it symmetrical?

A

poorly defined, asymmetrical

46
Q

What is the typical treatment of ChondroSarcoma?

A

Radical Surgical Ablation

47
Q

About what % of chondrosarcomas metastasize?

A

12%

48
Q

Why is 5 year survival not a good indicator of chondrosarcoma prognosis?

A

recurrence can take more than 5 years

49
Q

New studies show chondrosarcoma to have a better prognosis than _________

A

osteosarcoma

50
Q

What is the 5 year survival for chondrosarcoma?

A

65-90%

51
Q

What is the 10 year survival for Chondosarcoma?

A

50-70%

52
Q

What is the 15 year survival for chondrosarcoma?

A

slightly worse than 50-70% (the 10 yr rate)

53
Q

What is the cell of origin for Ewings sarcoma? What is the embriological origin?

A

uncertain! maybe bone marrow?…embryo: neuroECTODERMAL

54
Q

While the cell of origin for Ewing’s sarcoma is uncertain, it HAS been found to be a consistent genetic defect…WHAT is the defect??

A

translocation of 11;22

55
Q

Ewing’s sarcoma is ___-___% of ALL primary bone tumors

A

6-10%

56
Q

Which two bones account for more than HALF of all cases of Ewing’s Sarcoma?

A

pelvic bones and femur

57
Q

What % of Ewing’s Sarcoma occurs in the jaws?

A

less than 3%

58
Q

What are the 2 most common age groups for Ewing’s sarcoma?

A

children and adolescents

59
Q

What % of Ewing’s sarcoma patients are under the age of 20?

A

80%

60
Q

Ewing’s sarcoma is rare under age ___ or over age ___

A

5…30

61
Q

What race and gender is most common for Ewing’s sarcoma?

A

caucasian males (male 3:2)

62
Q

In Ewing’s Sarcoma: Pain and _____ of soft tissue overlying bone ________ pain, Varies from ____ to severe

A

swelling…Intermittent..dull

63
Q

What two signs of teeth and sensation are COMMON in Ewing’s sarcoma?

A

loosening of adjacent teeth and paresthesia

64
Q

What are the 3 conditions we have discussed that cause loosening of the teeth?

A

1.osteosarcoma 2.Chondrosarcoma 3.Ewing’s sarcoma

65
Q

Which arch is more affected in Ewing’s sarcoma?

A

mandible

66
Q

IF Ewing’s sarcoma causes systemic symptoms, what 3 are likely to take place?

A

1.Fever 2.leukocytosis 3.elevated ESR (erythrocyte sedimentation rate)

67
Q

Radiograhic features of Ewing’s sarcoma: Irregular, asymmetric radio______

A

radioLUCENT

68
Q

Radiograhic features of Ewing’s sarcoma: Ill defined ______

A

borders

69
Q

Radiograhic features of Ewing’s sarcoma: corticated? not corticated?

A

typically not corticated

70
Q

Radiograhic features of Ewing’s sarcoma: Reduplication of ______ may be present

A

cortex

71
Q

Radiograhic features of Ewing’s sarcoma: ________ reaction to the presence of underlying tumor

A

Periosteal

72
Q

Radiograhic features of Ewing’s sarcoma: Produces CHARACTERISTIC “_________” pattern

A

“onion skinning”

73
Q

Radiograhic features of Ewing’s sarcoma: Common in _____ bone lesions Rarely seen in _____

A

long bones….jaws

74
Q

What has the prognosis of Ewing’s sarcoma been historically described as?

A

DISMAL

75
Q

What are the three typical treatments of Ewing’s sarcoma today?

A

1.surgery 2.radiation 3.chemotherapy

76
Q

What is the range of survival rates for Ewing’s sarcoma?

A

40-80%

ORAL PATHOLOGY! (40 decks)

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