- osteoid osteoma - osteosarcoma - osteochondroma all start with O!

musculoskeletal tumors Flashcards by Jessica Buddenbaum

benign x ray findings

well defined, clear outline 2. surrounding rim of bone 3. not broken through the cortex 4. narrow zone of transition between lesion, normal bone

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name 3 bone cancers

osteoid osteoma - osteosarcoma - osteochondroma all start with O!

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name 2 cartilage cancers

enchondroma - chondrosarcoma

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demographic of osteoid osteoma

usually patients under 20 or 25

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benign cordial reaction with a radiolucent nidus

osteoid osteoma

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location of osteoid osteoma

diaphysis

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NSAIDs work in

osteoid osteoma

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symptoms of osteoid osteoma

intense pain at rest/night in the long bone… no systemic symptoms

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fever with osteoid osteoma?

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osteosarcoma

soft tissue mass

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associated with Rb

osteosarcoma

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demographic of osteosarcoma

typically age 5-25, common in 10-20

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may be secondary to Pagets disease

osteosarcoma

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complications of Paget disease in the elderly

osteosarcoma and high output heart failure

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imaging shows a mixed Lucent and dense “sunburst” lesion (also has ill defined borders)

osteosarcoma

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pleomorphic cells producing osteoid

osteosarcoma

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malignant osteoblast proliferation

osteosarcoma

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Codmans angle

osteosarcoma

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location of osteosarcoma

metaphyseal

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usually grows away from the metaphysis

osteochondroma

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demographic of osteochondroma

childhood

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can be sessile or pedunculated

osteochondroma

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multiple hereditary exostoses

multiple osteochondromas

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inheritance pattern of multiple osteochondromas

autosomal dominant

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Ewing sarcoma

osteoid osteoma

osteosarcoma

osteoid osteoma histology

osteochondroma

Very commonly seen in hand

enchondroma

distal femoral enchondroma

usually metaphyseal, central in bone

enchondroma

age of enchondroma

\>30 yrs

enchondroma histology

most common osseous hand tumor

enchondroma

chondrosarcoma

Lytic changes Cortical involvement

“Bland” No or very little atypia Not very cellular; chondroid matrix

enchondroma histology

Older patient population than most other primary bone tumors

chondrosarcoma

age of chondrosarcoma

\>50

Chondroid tumors become more concerning as you move from ____ to \_\_\_\_

distal to proximal (pelvic, scapular lesions usually malignant; hand lesions almost always benign)

chondrosarcoma

Patient \>50/60 with enlarging hip/pelvis/shoulder mass

chondrosarcoma

simple unicameral bone cyst describe it

Well-circumscribed Central (not eccentric) No matrix mineralization Lucent

demographic of Fibrous dysplasia

Wide age range, may first present in childhood

can be associated with McCune Albright - café au lait, polyostotic FD, Endocrinopathy

Polyostotic fibrous dysplasia

fibrous dysplasia on imaging

ground glass appearance

fibrous dysplasia histology - Immature bony trabeculae (alphabet soup) with bland fibrous stroma

giant cell tumor benign or malignant

benign

demographic of giant cell tumor

age 30-50

where does giant cell tumor occur

epiphysis at the ends of long bones

Extends to subchondral surface (epiphyseal)

giant cell tumor

Giant cell tumor

contents of giant cell tumor

- no matrix calcification - No reactive sclerosis or periosteal reaction

Can occasionally be associated with fever, elevated ESR

Ewing sarcoma

age of ewing sarcoma

10-30

location of ewing sarcoma

diaphyseal or metaldiaphyseal

cytogenetics of ewing sarcoma

11:22 translocation

differential for new bony lesion in patient over 50

- Metastatic disease - Myeloma - Lymphoma

Often medullary but can compromise cortex

multiple myeloma

multiple myeloma - radiolucent - punched out appearance

carcinomas that tend to metastasize to bone

Lung (Lytic) Breast (Lytic or Blastic) Prostate (usually blastic) Renal (Lytic) Thyroid (Lytic) Lead kettle: PBKTL

Heterotopic bone formation in muscle

myositis ossificians

location for Myositis ossificans

quadriceps

Myositis ossificans can occur after

blunt trauma

myositis ossificans

paget disease can be associated with

osteosarcoma

Usually, older patient (\> 50 or 60), skeletal pain, bone bowing, elevated alk phos, possible high-output heart failure

paget disease

metaphyseal bone tumors happen in these diseases

OGS NOF Enchondroma (finger--all bets are off) Osteochondroma Chondrosarcoma Simple cyst Mets Myeloma

disaphyseal bone tumors

## Footnote Osteoid osteoma Ewing’s sarcoma Mets Myeloma