Lec 16 Bone Tumor Flashcards
What are of bone most likely to have infection/tumor?
metaphysis
Who gets an osteoid osteoma?
young adults < 25 yo; M > F
What is location of osteoid osteoma?
in cortex of long bones
What are characteristics of osteoid osteoma?
- benign, sharply demarcated osteoblastic
- < 2 cm in size
- pain at night relieved by aspirin
What is most common primary bone malignancy?
osteosarcoma
What are characteristics of osteosarcoma?
- tumor produces bone matrix
- present w/ pain, swelling, pathologic fracture, high alkaline phosphatase
Who gets osteosarcoma?
young adults < 20; smaller peak after age 50
What is location of osteosarcoma?
near sites of active bone growth = metaphysis
Where does osteosarcoma metastasize?
hematogenously to lungs
What is treatment for osteosarcoma?
pre-op chemo + surgery
good prognosis
What are characteristics of osteochondroma?
- most common benign bone tumor
- can be solitary or multiple
- neoplastic lateral outgrowth from growth plate w/ cartilaginous cap
- rarely transforms to chondrosarcoma
- synchronously grows w/ normal epiphyseal growth plate; stops growing when skeletal maturity reached
Who gets osteochondroma?
males < 25 yo
What is osteochondromatosis?
familial disorder with multiple hereditary osteochondromas
autosomal dominant
have asymmetric retardation of longitudinal bone growth
manifests in adolescence and ceases in adulthood
What is an enchondroma?
benign intramedullary hyaline cartilage neoplasm
Where does enchondroma occur?
appendicular skeleton in medullary region
What are characteristics of enchondroma?
- variable presentation: aysmptomatic, painless swelling
- can resemble chondrosarcoma
What is enchondromatosis [ollier disease]?
rare non hereditary disorder of multiple intramedullary cartilaginous tumors
affected limb may be shortened or deformed; rarely progresses past puberty
may develop assocaited chondrosarcoma or osteosarcoma
What is maffucci syndrome?
enchondromatosis + hemangiomas
increased susceptibility to development of sarcoma
What is chondrosarcoma?
malignant mesenchymal tumor of malignant cartilaginous cells
can be primary or arise from previous enchondroma or osteosarcoma
Where is chondrosarcoma located?
in medullary cavity
Who gets chondrosarcoma?
men 30-60 yo [peak 55]
What is treatment for chondrosarcoma?
does not respond to chemo –> must remove surgically
What do you see in ewing sarcoma radiographically?
- destructive lytic lesion
- onion skin periosteal reaction
Who gets ewing sarcoma?
10-15 yo; M > F
caucasians
Where is ewing sarcoma located?
diaphysis of long bones
What are characteristics of ewing sarcoma?
have pain in area, fever, sick = mimics osteomyeltis
warm, enlarging mass
from neuroectoderm –> mesenchymal cells = small round blue cel tumor; no matrix production
What is treatment for ewing?
chemo, radiation, surgery
What is a fibrous cortical defect?
non neoplastic intracortical proliferation of fibrous tissue and histiocytes
seen in kids M > F in metaphysis
What is a non-ossifying fibroma?
fibrous cortical defect 2-5 cm
in adolescents
expanded into medullary cavity
may present w/ pathologic fracture
What do you see on xray with non ossifying fibroma?
well circumscribed lytic lesion with slightly sclerotic rim
in metaphysis
What is monostotic fibrous dysplasia?
single bone fibrous dysplasia
stops when growth plate closes
What is fibrous dysplasia?
benign fibroosseus tumor
intramedullary proliferation of fibrous tissue + woven bone –> failure to differentiate to mature bone
Who gets fibrous dysplasia?
age < 30 yo [kids and young adults]
What are 3 types of fibrous dysplasia?
monostotic = single bone
polystotic = multiple bones
mccune albright syndrome = polyostotic FD + endocrine abnormalities [precocious puberty] + cafe au lait spots
What are signs of mccune albright syndrome
polyostotic FD + endocrine abnormalities [precocious puberty] + cafe au lait spots
What happens in polyostotic fibrous dysplasia?
present in young pts than monostotic; continues into adulthood
have craniofacial invovlement often
What is a giant cell tumor?
benign locally aggressive; usually solitary tumor around knee
Who gets a giant cell tumor?
20-40 yo
Where is giant cell tumor located?
epiphysis
