MSK path VII Flashcards
what are the most likely cartilage forming tumors ages 10-30
chondroblastoma and chondromyxoid fibroma
what cartilage forming tumor is more common in older patients >25 y.o
clear cell chondrosarcoma
what is osteochondroma
exostosis
benign cartilage capped tumor attached to skeleton by stalk
msot common benign bone tumor
osteochondroma
what makes cap of osteochondroma
hyaline cartilage
are osteochondromas lytic lesions
no
clinical course osteochondroma
stop growing at time of growth plate closure
Symptomatic tumor Tx osteochondroma
excision
when can osteochondromas progress to chondrosarcomas
in those with multiple hereditary exostosis
chondromas
benign tumors of hyaline cartialge
enchondral region of bone
what is name of chondroma arising in medullary cavity
enchondroma
what are chondromas called that arise on surface of bone
juxtacortical chondromas
most common intraosseous cartilage tumor
enchondromas
presentation enchondroma
solitary metaphyseal lesion of tubular bones of hands and feet
radiograph of chondroma
circumscribe lucencies with central irregular calcifications
nonhereditary disorders with multiple enchondromas
ollier disease and Maffucci syndrome
how is Maffucci syndrome distinguished
spindle cell hemangioma
morphology enchondroma
< 3cm
gray blue and translucent
well circumscribe nodules of hyalin with benign chondrocytes
get ollier disease and maffucci syndrome enchondromas mixed with what
chondrosarcomas
casing of enchondroma
thin layer reactive bone
Maffucci syndrome patients at risk of developing what
ovarian carcinomas and brain gliomas
chondrosarcoma
maligant tumor that produces cartilage
subclassifications chondrosarcomas
conventional (produce hyaline)
clear cell
de differentiated
mesenchymal
age of chondrosarcoma
> 40 y.o
where do chondrosarcomas arise
axial skeleton, pelvis, shoulder, ribs
XR chondrosarcoma
calcified matrix with foci of flocculent densities
presentation chondrosarcoma
painful!
progressively enlarging mass
nodular pattern of cartilage produce scalloping
matrix in chondrosarcomas
gelatinous or myxoid, can ooze
grade 3 chondrosarcoma
high cellularity extreme pleomorphism with bizarre tumor giant cells and mitoses
scalloping of bone on XR and increased Ca 65 y.o
chondrosarcoma
prognosis grade 1 chondrosarcoma
5 yr 80-90%
where do chondrosarcomas mets to
lungs
Tx conventional chondrosarcoma
wide surgical excision
Tx mesenchymal and dedifferentiated tumors
excised and Tx with chemo because aggressive
Ewing Sarcoma
malignant bone tumor characterized by primitive round cells without obvious differentiation
What are in ewing sarcoma family tumors
ewing sarcoma
and primitive neuroectodermal tumor PNET
bone tumors with youngest age presentation <20 y.o
ewing sarcoma family tumors
where do ewing tumors arise
diaphysis of long tubular bones in medullary cavity
clinical presentation ewing sarcomas
pain, tender warm and swollen
sometimes like infection: fever, inc sed rate, anemia, leukocytosis
radiograph ewings
destructive lytic lesion with permeative margins that extend into soft tissues
onion skin fashion of periosteal reaction
ewing sarcoma
translocation in ewing sarcoma
11;22
gross morphology ewing sarcoma
soft tan white and hemorrhage and necrosis
sheets of uniform small cells that are larger thatn lymohocytes
little cytoplasm
homer wright rosettes (round groupings with central fibrillary core)
neuroectoderm differentiation—- ewings sarcoma
rossetting and PAS +
ewings sarcoma
Tx ewing like tumors and ewings
neoadjuvant chemo with surgical excision
+/- irradiation
prognostic finding for ewings
amount of chemo-induced necrosis
