Intro to MSK neoplasms, osteochondroma, osteoid, osteoma, Malignant, Osteosarcoma, Multiple myeloma, metastatic...ST tumors Flashcards
Benign : Malignant ratio
100:1
Begnign neoplasm always innocuous?
Osteoblastomas in spine cause complications req. surgery
Osteoclastic resorp in benign may cause pathologic fracture
Some benign -> malignant
Skeletal neoplasm metastasize to ____ by bloodstream
lung
Most common benign MSK tumor
Most common malignant MSK tumor
Men: women incidence
Osteochondroma and Osteoid oestoma (bone tumor), enchondroma
Metastatic neoplasm - bone malignancy + 2ndry (metastatic) neoplasm bone
Meultiple myeloma - Primary neoplasm (plasma c. Cancer)
3:1
Primary Bone tumors freq
Rare, <1% diag
50% bone marrowmultiple myeloma
benign: metastatic bone tumor
Primary sites of primary tumor
10:1
Breast, prostate, lung, kidney, thyroid
Osteoid Osteoma
Grows on another bone (osteoblastic lesion), males <25yr
0 pot for malignancy
Chondroma
Central in bone, aged 10-30
Benign bone tumor cell type
Osteoid osteoma - bone c.
Chondroma - Cartilage c.
Nonossifying Fibroma (NOF) - fibroblasts
Giant c. tumor - osteoclast
Non-ossifying Fibroma (NOF)
most common benign in children, 2x often in males. 30-40% <20 yrs
No malignancy, go away maturity
Giant C.
Demo
Malig risk factor/recur+ location
Clin man
20-30s, osteoclast-like c., epiphysis
Malignancy uncommon but low grade sarcoma, 50% may recur locally or sarcoma - high recurrance and pot for malig
20-55 yrs, more often in chinese, 20% popN, -60% around knee
Slow pul meta, excised eff
Malignant risk factors
Paget’s
Li-Fraumeni syndrome
Chemo (cyclophosphamide)
Ionizing rad
Hereditary retinoblastoma
More often in males
Malignant bone tum types
Osteosarcoma - osteoblasts
Chondrosarcoma - chondrocytes
Ewing’s sarcoma - undiff bone marrow c.
Multiple myeloma - bone marrow c.
Osteosarcoma (location, demographic)
Clin man
Risk of surgery
Metaphysis of long bone, 50% in knee, highly malignant.
Male children, + < 30yrs
(P) + mass rare system (fever, warm), biopsy diag.
90% lung metases early on
Pulmonary metases. No amp. 90% survival, 5-yr cure 70-80%, radiotx ineffective
Chondrosarcma (location, epidemiology, demog)
Clin man
Tx
pelvic and shoulder girdles, 2nd most common solid bone cancer adults
Men 40-60
Exist for years w/o sym, less metastatic than osteosarcoma, metastasizes -lung, other bone, organ
Surgical removal, radi ineff, chemo lim - slow growth
Ewing’s Sarcoma (epidem, location, risk factors)
Clin man
Tx
Prog
2nd most common primary malig tumor in children, adol, 80% in <20, rare in blacks
Pelvis + lower extremities
Caucasian, parental occupation -pesticide expos, parental smoking
Prog (P), swell, path, misdig w/ osteomyelitis
Chemo (metastases), radiotX (local), immuno, surgery
High recurrence, metastases
35% lung metastases @ diag - 25% survival. Distal sites, smaller better prog.
Multiple Myeloma (etio, location, epidem)
Clin manif
Plasma c. dyscrasia (abn)
Most common: spine, pelvis, skull
patients die w/i 1-3 diag, old age pt >45yrs
Malignant of one plasma c. -> overgrowth of bone marrow via clonal (monoclonal cond).
ID immunoglobulin neop secret, punched out holes of surrounding blood-forming bone -> hypercalcemia and deposition in kidney/organ
Kidney fail usually cause of death or infection
Anemia, leukopenia, thrombocytopenia -> pathologic fracture
Soft tiss tumor low grade vs malignant
Local aggressive, often recur no metasize vs. metastasize to lung
Soft tiss tumor prog
small superficial tumor better prog, 40% 5yr survival rate
Rhabdomyosarcoma
children - extremities, trunk.
Adults - more in small muscle - extr mm eye
Synovial Sarcoma
young adults, re: mesenchymal c. in aponeuroses not synovium
Polymorphous c. sarcoma
Predom soft tiss sarcoma in adult, rapid metastasize
Liposarc
2nd most common sarcoma in adult
