MSK path VII

Question 1

what are the most likely cartilage forming tumors ages 10-30

Answer 1

chondroblastoma and chondromyxoid fibroma

Question 2

what cartilage forming tumor is more common in older patients >25 y.o

Answer 2

clear cell chondrosarcoma

Question 3

what is osteochondroma

Answer 3

exostosis

benign cartilage capped tumor attached to skeleton by stalk

Question 4

msot common benign bone tumor

Answer 4

osteochondroma

Question 5

what makes cap of osteochondroma

Answer 5

hyaline cartilage

Question 6

are osteochondromas lytic lesions

Answer 6

no

Question 7

clinical course osteochondroma

Answer 7

stop growing at time of growth plate closure

Question 8

Symptomatic tumor Tx osteochondroma

Answer 8

excision

Question 9

when can osteochondromas progress to chondrosarcomas

Answer 9

in those with multiple hereditary exostosis

Question 10

chondromas

Answer 10

benign tumors of hyaline cartialge

enchondral region of bone

Question 11

what is name of chondroma arising in medullary cavity

Answer 11

enchondroma

Question 12

what are chondromas called that arise on surface of bone

Answer 12

juxtacortical chondromas

Question 13

most common intraosseous cartilage tumor

Answer 13

enchondromas

Question 14

presentation enchondroma

Answer 14

solitary metaphyseal lesion of tubular bones of hands and feet

Question 15

radiograph of chondroma

Answer 15

circumscribe lucencies with central irregular calcifications

Question 16

nonhereditary disorders with multiple enchondromas

Answer 16

ollier disease and Maffucci syndrome

Question 17

how is Maffucci syndrome distinguished

Answer 17

spindle cell hemangioma

Question 18

morphology enchondroma

Answer 18

< 3cm
gray blue and translucent
well circumscribe nodules of hyalin with benign chondrocytes

Question 19

get ollier disease and maffucci syndrome enchondromas mixed with what

Answer 19

chondrosarcomas

Question 20

casing of enchondroma

Answer 20

thin layer reactive bone

Question 21

Maffucci syndrome patients at risk of developing what

Answer 21

ovarian carcinomas and brain gliomas

Question 22

chondrosarcoma

Answer 22

maligant tumor that produces cartilage

Question 23

subclassifications chondrosarcomas

Answer 23

conventional (produce hyaline)
clear cell
de differentiated
mesenchymal

Question 24

age of chondrosarcoma

Answer 24

> 40 y.o

Question 25

where do chondrosarcomas arise

Answer 25

axial skeleton, pelvis, shoulder, ribs

Question 26

XR chondrosarcoma

Answer 26

calcified matrix with foci of flocculent densities

Question 27

presentation chondrosarcoma

Answer 27

painful!
progressively enlarging mass
nodular pattern of cartilage produce scalloping

Question 28

matrix in chondrosarcomas

Answer 28

gelatinous or myxoid, can ooze

Question 29

grade 3 chondrosarcoma

Answer 29

high cellularity extreme pleomorphism with bizarre tumor giant cells and mitoses

Question 30

scalloping of bone on XR and increased Ca 65 y.o

Answer 30

chondrosarcoma

Question 31

prognosis grade 1 chondrosarcoma

Answer 31

5 yr 80-90%

Question 32

where do chondrosarcomas mets to

Answer 32

lungs

Question 33

Tx conventional chondrosarcoma

Answer 33

wide surgical excision

Question 34

Tx mesenchymal and dedifferentiated tumors

Answer 34

excised and Tx with chemo because aggressive

Question 35

Ewing Sarcoma

Answer 35

malignant bone tumor characterized by primitive round cells without obvious differentiation

Question 36

What are in ewing sarcoma family tumors

Answer 36

ewing sarcoma

and primitive neuroectodermal tumor PNET

Question 37

bone tumors with youngest age presentation <20 y.o

Answer 37

ewing sarcoma family tumors

Question 38

where do ewing tumors arise

Answer 38

diaphysis of long tubular bones in medullary cavity

Question 39

clinical presentation ewing sarcomas

Answer 39

pain, tender warm and swollen

sometimes like infection: fever, inc sed rate, anemia, leukocytosis

Question 40

radiograph ewings

Answer 40

destructive lytic lesion with permeative margins that extend into soft tissues

Question 41

onion skin fashion of periosteal reaction

Answer 41

ewing sarcoma

Question 42

translocation in ewing sarcoma

Answer 42

11;22

Question 43

gross morphology ewing sarcoma

Answer 43

soft tan white and hemorrhage and necrosis
sheets of uniform small cells that are larger thatn lymohocytes
little cytoplasm

Question 44

homer wright rosettes (round groupings with central fibrillary core)

Answer 44

neuroectoderm differentiation—- ewings sarcoma

Question 45

rossetting and PAS +

Answer 45

ewings sarcoma

Question 46

Tx ewing like tumors and ewings

Answer 46

neoadjuvant chemo with surgical excision

+/- irradiation

Question 47

prognostic finding for ewings

Answer 47

amount of chemo-induced necrosis