MSKS Pathology Lecture 3_Bone Tumors

Question 1

Describe Giant Cell Tumors

Answer 1

They are non metastatic but are very destructive locally. They form large multinucleated cells that contain neoplastic osteoblast (which produces losts of RANKL) and many osteoclasts. THis results in losts of bone destructions, tyipically in the epiphisis of the long bones.

Question 2

What is an Osteochondroma

Answer 2

a benign cartilagecapped tumor that is attached to the underlying skeleton by a bony stalk

Question 3

How is osteoblastoma typically treated?

Answer 3

Typically curetted or excised

Question 4

What is a Ewing sarcoma

Answer 4

a malignant tumor composed of primitive round cells that arises in the bone marrow in the daiphysis of long tubular bones, it invades the cortex and then exits into the surrounding tissue.

Question 5

What demographic is most affected by this>

Answer 5

Caucasians boys

Question 6

How is Osteoid osteoma typically treated?

Answer 6

radiofrequency ablation,

Question 7

Do Osteoid osteoma and osteoblastoma become malignant?

Answer 7

Malignant transformation is rare.

Question 8

What is the malignancy of osteochondromas?

Answer 8

Rarely in sporadic cases, but more commonly in those with multiple hereditary exostosis, they give rise to a chondrosarcoma.

Question 9

What is the most common metastisis?

Answer 9

hematogenous spread to the lungs

Question 10

What diseases increase the frequency of chondromas?

Answer 10

Ollier disease and Maffucci syndrome are disorders characterized by multiple enchondromas

Question 11

Where do Osteoblastomas typically occure/ what is their size? Are they responsive to analgesics?

Answer 11

Osteoblastomas typically occure in the posterior compartment of the vertebrae. They are are larger than 2 cm in dia and they do not respond to NSAIDs

Question 12

How do osteosarcomas present?

Answer 12

typically present as painful, progressively enlarging masses. Because they weaken the bone by invading the tissue, sometime sudden bone fracture is the first symptome.

Question 13

How large are Osteoid osteomas and who do they typically effect?

Answer 13

They are less than 2 cm in Dia and most often effect adolecent men

Question 14

Where do Osteoid osteomas typically occure and are they responsive to analgesics?

Answer 14

50% of cases arise in the femur or tibia. Pain can me amnaged by NSAIDs

Question 15

What are Chondromas and where do they occure?

Answer 15

benign tumors of hyaline cartilage that usually occur in bones of endochondral origin. They arise within the medullary cavity (enchondroma) or on the cortical surface (juxtacortical chondroma)

Question 16

where do Osteochondromas occure?

Answer 16

develop only in bones of endochondral origin and arise from the metaphysis near the growth plate of long tubular bones, especially about the knee

Question 17

How do Chondrosarcomas typically present and how are they treated?

Answer 17

usually present as painful, progressively enlarging masses. The treatment of conventional chondrosarcoma is wide surgical excision

Question 18

What is an Osteosarcoma

Answer 18

It is a malignant tumor that produces osteoid matrix or mineralized bone

Question 19

Where do Chondrosarcoma typically occure?

Answer 19

In the axial skeleton

Question 20

What demographic is at the highest risk for Osteosarcomas?

Answer 20

Adolecent men (effects men at a rate of 1.6:1 as compaird to women). 75% of cases happen under the age of 20. There is a small resurgence of Osteosarcoma in older adulthood. Typically it is secondary to something like pagets disease or radio therapy

Question 21

Where are Osteosarcoma most common?

Answer 21

metaphyseal regions of the distal femur and proximal tibia (basically the growth plates of the highest rate of growth.)

Question 22

Describe and Aneurysmal bone cyst

Answer 22

is a benign tumor of bone characterized by multiloculated blood-filled cystic spaces that may present as a rapidly growing expansile tumor