L19- Tumors of Cartilage (+ non-bone cell tumors) Flashcards
Most cartilage tumors are (benign/malignant). (2) is the most common tumor found in bone, mainly affecting (3) age group.
1- benign
2- osteochondroma
3- young adults
list the types of cartilage and whether they are found in tumors, normal cartilage, or both
-Hyaline: both
- Fibrocartilage: normal, rare in tumors
- Elastic: normal, extremely rare in tumors
-Myxoid: only tumors
Osteochondroma:
- arises from (1)
- affects (2) bones, include specifics
- (3) related genetic changes
1- displaced fragments of growth plate
2- metaphysis of bones with endochondral ossification
3- EXT gene family mutations
Osteochondroma:
- (1) gross appearance
- (2) radiological appearance
1- exophytic growth with surrounding cartilage
2- medullary cavity extending into stalk of exophytic growth
describe histology of osteochondroma
- cartilagenous cap with disorganized growth plate like cartilage (hyaline cartilage)
- bony matrix forming new trabeculae structures
- medullary cavity extending into stalk of exophytic growth
Endochondroma:
- (benign/malignant)
- (2) cartilage type
- (3) affected bones and specific parts
- (4) is an important feature of development different from other growing tumors
1- benign
2- hyaline, myxoid cartilage
3- long bones- *Fingers most common // medullary cavity of metaphysis, diaphysis
4- may erode cortex - will not invade cortex
Endochondroma:
- (1) main clinical presentation
- (solitary/syndromic) presentation
- may develop into (3)
1- pathological fracture, or just pain
2- both: mainly solitary – syndromic (Ollier’s, Mafucci’s = multiple enchondrocytes)
3- chondrosarcoma (very rare)
Endochondroma:
- (1) radiological appearance
- (2) histological features
1- translucent nodule of cartilage w/ calcified cartilage in center surrounded by cortical bone
2- tumor cells form hyaline cartilage – reactive bone surrounds tumor nodule – thinning of bone overall
describe the features of the different multiple endochondromatosis
- multiple sites of endochondromas
- non-hereditary
- 20% develop into chondrosarcomas
Ollier’s disease: disfiguring
Mafucci’s disease: endochondromas + soft tissue vascular tumors –> 100% develop another extraskeletal malignancy
Chondrosarcoma:
- (1) affected age group
- (2) affected bones
- may arise from (3)
1- older adults
2- pelvis, humerus, proximal femur
3- endochondroma (low grade)
Chondrosarcoma:
- (1) is the main feature seen on gross imaging
- (2) are the main features seen in histology
1- tumor invasion through cortical bone into surrounding soft tissue
2- malignant chondrocytes: multinucleated, surrounded by cartilage with possible calification
Giant Cell tumor of bone:
- (1)% of all primary bone tumors
- (2) characterization of growth / aggressiveness
- often confused with (3)
1- 4-5%
2- benign locally aggressive tumor – no metastasis
3- osteosarcoma
Giant cell tumors of bone:
- (1) affected age group
- (2) location of tumor
1- 20-40 y/o
2- epiphysis of long bones
Giant Cell tumor of bone:
- (1) radiographical appearance
- (2) histological cell features
1- expanding lytic lesion = ‘soap bubble appearance’
2- tumor cells: fibroblastic, histiocytic
PNET = (1):
- (2) prevalence
- (3) related genetic changes
- (4) affected age groups
- (5) affected part of bone
- (6) prognosis
1- Ewing’s Sarcoma, Primitive Neuroectodermal Tumor
2- 6-10% of all primary malignant bone tumors
3- t(11;22), t(21;22)
4- youngest population of malignant tumors
5- diaphysis of long bones
6- dismal (some improvement with chemotherapy)
