Location of Tumors Exam 3

Question 1

Giant cell tumor

Location

Answer 1

85% long bones: distal femur and proximal tibia (50-60%), distal radius and proximal humerus
-15% in flat bones: pelvis, sacrum near SIJ*, spine 5%, rib, and skull

Question 2

Solitary osteochondrosarcoma

Location

Answer 2

sessile: broad base and no stalk: humerus & scapula

-pedunculated: long stalk w/ a cart. Cap, common in knees, hip, and ankle
“coat hanger exostosis” and “cauliflower cap”

• met of long bones: femur + tibia (50%) humerus, prox radius
• flat bones: scap, ribs, pelvis, spine (1-5%, thoracics)
• any bone formed by endchondral ossification

Question 3

Hereditary multiple exostosis
(HME)
“diaphyseal achalasia”

Location

Answer 3

• metaphysis of long bones: multiple and bilateral, knees, shoulders, ankles, hips, wrists
• flat bones: pelvis, ribs, scap

Question 4

Simple/solitary/unicameral bone cyst

Location

Answer 4

60-75%: proximal humerus and femur, fibula, calcaneal neck, talus

-active/latent

Question 5

Aneurysmal bone cyst

Location

Answer 5

spine 30%: predeliction for the post elements (spinous, lamina, pedicle, TP

• long bones: metaphysic of femur, tibia, fibula, humerus
• flat bones: pelvis

Question 6

Osteoblastoma

Location

Answer 6

spine in ~40%: particularly involving the posterior neural arch structures

• long bones ~30%: femurs, tibia, humerus, radius, fibula
• small bones: hands and feet~25%

Question 7

Osteoid Osteoma

Location

Answer 7

• meta-/diaphysis of long bones in (73%): proximal femur, proximal tibia, humerus
• spine (14%): predominately the posterior elements of lower thoracic + upper lumbars creating a painful scoliosis (concave*)
• no bone is exempt

Question 8

Osteoma

Location

Answer 8

• para nasal sinuses (frontal & ethmoid)
• inner/outer table of the calvarium (usually from external table)
• occasion ally mandible or nasal bone

Question 9

Enchondroma

Location

Answer 9

40% in small bones of the wrists and hands (phalanges>metacarpals)

• long bones: femur, tibia, humerus, radius, ulna, feet, ribs
• usually central & meta/diaphyseal

Question 10

Enchondromatosis/Ollier’s

Location

Answer 10

hand and feet deformity

Question 11

Hemangiomas

Location

Answer 11

• vertebral body in the lower thoracics/upper lumbars

- calvarium w predilection for the frontal bone

Question 12

Chondroblastoma

Location

Answer 12

develops around an apophysis or epiphysis in a subarticular location

-2/3 found in lower ext: proximal femur (23%), distal femur (20%), prox tibia (17%), proximal humerus (17%), tarsal bones

Question 13

Fibrous cortical

Location

Answer 13

metaphyseal cortex of long bones of the lower ext: *posterior-medial surface of the distal femur, tibia, fibula, prox femur

-other less common sites: ilium, ribs, or proximal humerus

Question 14

Nonossifying fibroma

Location

Answer 14

affects long bones of the lower ext: *distal tibia, distal femur, proximal tibia, fibula, & occasionally proximal humerus

-eccentric and metadiaphyseal

Question 15

Paget’s disease

Location

Answer 15

• usually polyostotic and asymmetric
• pelvis>lumbar spine> thoracic spine> proximal femur> calvarium> scapula> distal femur> proximal tibia> proximal humerus

Question 16

Chordoma

Location

Answer 16

50% sacrococcygeal area

• 35% clivus of Blumenbach
• 15% spinal axis (C2)

Question 17

Multiple myeloma

Location

Answer 17

Skeletal

• vertebrae, thoracic & lumbars
• pelvis, skull, ribs
• clavical & scapula
• femur & humerus

Question 18

Solitary plasmocytoma

Location

Answer 18

vertebra> pelvis> skull> sternum> ribs

Question 19

Osteosarcoma

Location

Answer 19

Skeletal location:
-distal femur 40%, proximal tibia 16%, proximal humerus 15%

• 75% occur in the metaphysic next to the growth plate
• cylindrical bone 50 yrs

Question 20

Chondrosarcoma

Location

Answer 20

• proximal humerus
• neck of the femur
• ribs, sternum
• pelvis* (mc)

Question 21

Ewing’s Sarcoma

Location

Answer 21

-long tubular bones (60%): femur, tibia, humerus, fibula, particularly 20 yrs