Intro to MSK neoplasms, osteochondroma, osteoid, osteoma, Malignant, Osteosarcoma, Multiple myeloma, metastatic...ST tumors

Question 1

Benign : Malignant ratio

Answer 1

100:1

Question 2

Begnign neoplasm always innocuous?

Answer 2

Osteoblastomas in spine cause complications req. surgery

Osteoclastic resorp in benign may cause pathologic fracture

Some benign -> malignant

Question 3

Skeletal neoplasm metastasize to ____ by bloodstream

Answer 3

lung

Question 4

Most common benign MSK tumor

Most common malignant MSK tumor

Men: women incidence

Answer 4

Osteochondroma and Osteoid oestoma (bone tumor), enchondroma

Metastatic neoplasm - bone malignancy + 2ndry (metastatic) neoplasm bone

Meultiple myeloma - Primary neoplasm (plasma c. Cancer)

3:1

Question 5

Primary Bone tumors freq

Answer 5

Rare, <1% diag

50% bone marrowmultiple myeloma

Question 6

benign: metastatic bone tumor

Primary sites of primary tumor

Answer 6

10:1

Breast, prostate, lung, kidney, thyroid

Question 7

Osteoid Osteoma

Answer 7

Grows on another bone (osteoblastic lesion), males <25yr

0 pot for malignancy

Question 8

Chondroma

Answer 8

Central in bone, aged 10-30

Question 9

Benign bone tumor cell type

Answer 9

Osteoid osteoma - bone c.

Chondroma - Cartilage c.

Nonossifying Fibroma (NOF) - fibroblasts

Giant c. tumor - osteoclast

Question 10

Non-ossifying Fibroma (NOF)

Answer 10

most common benign in children, 2x often in males. 30-40% <20 yrs

No malignancy, go away maturity

Question 11

Giant C.
Demo

Malig risk factor/recur+ location

Clin man

Answer 11

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

Question 12

Malignant risk factors

Answer 12

Paget’s

Li-Fraumeni syndrome

Chemo (cyclophosphamide)

Ionizing rad

Hereditary retinoblastoma

More often in males

Question 13

Malignant bone tum types

Answer 13

Osteosarcoma - osteoblasts

Chondrosarcoma - chondrocytes

Ewing’s sarcoma - undiff bone marrow c.

Multiple myeloma - bone marrow c.

Question 14

Osteosarcoma (location, demographic)

Clin man

Risk of surgery

Answer 14

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

Question 15

Chondrosarcma (location, epidemiology, demog)

Clin man

Tx

Answer 15

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

Question 16

Ewing’s Sarcoma (epidem, location, risk factors)

Clin man

Tx

Prog

Answer 16

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.

Question 17

Multiple Myeloma (etio, location, epidem)

Clin manif

Answer 17

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

Question 18

Soft tiss tumor low grade vs malignant

Answer 18

Local aggressive, often recur no metasize vs. metastasize to lung

Question 19

Soft tiss tumor prog

Answer 19

small superficial tumor better prog, 40% 5yr survival rate

Question 20

Rhabdomyosarcoma

Answer 20

children - extremities, trunk.

Adults - more in small muscle - extr mm eye

Question 21

Synovial Sarcoma

Answer 21

young adults, re: mesenchymal c. in aponeuroses not synovium

Question 22

Polymorphous c. sarcoma

Answer 22

Predom soft tiss sarcoma in adult, rapid metastasize

Question 23

Liposarc

Answer 23

2nd most common sarcoma in adult