Neoplastic Flashcards
what is the most common malignant primary bone tumor?
osteosarcoma
Where do osteosarcomas usually prsent?
metaphysis of long bone up to the epiphyseal plate (limited by epiphyseal plate-can be above or below not past)
(hematogenous spread to lungs) (site of greatest growth)
Knee >hip > shoulder.> jaw and face
Who is most often affected by osteosarcomas?
<20yo teens
peak in elderly as well
males 6x more likley
what is the clinical presentation of osteosarcoma?
painful/weak
enlarging mass
swelling
What gene is osteosarcoma associated with?
RB gene mutation
what type of cells make up an osteosarcoma?
mesenchymal
What does a histologic look of osteosarcoma look like?
stroma(sarcomatous) surrounded by new osteoid bone matrix overproduction
What does an x-ray of osteosarcoma look like?
- at metaphysis of long bones limited by epiphyseal plate
- codman’s triangle of periosteum
- radioopaque bone formed outside of bone
How do you diagnose an osteosarcoma?
bone scan and biopsy.
Rule out other sites or “Skipped lesion” in same bone
What are 3 examples of benign bone tumors?
osteiod osteoma
osteoblastoma
osteoma
How do osteiod osteomas present?
response to aspirin (decrease pain) painful radiolucent area around netus in bone metaphysis and diaphysis of long bones(appendicular) mostly males ages 5-35yo
How do osteoblastomas present?
in the posterior elements in spine
mostly males
How do osteomas present?
subchondral and endosteal bone
of face
in lamellar and woven bone
What are some benign cartilaginous tumors?
osteochondroma
chondroma
chondroblastoma(rare)
how do osteochondromas present?
in endochondral cartilage
in metaphysis of long bone -endochondral
x-ray shows mushroom forming off of metaphysis
males 20-30 years
what is the etiology of osteochondromas?
ext genes are inactive
what is the presentation of chondroma?
in hyaline cartilage(MC interoseous tumor)
20-50 yo
What are the benign fibrous tumors?
FCD
fibroma
fibrous dysplasia
fibroma presents how?
fibrous cortical defect
>5cm
non-ossifying
fibrous cortical defect presents how?
distal femur or distal tibia in metaphysis
age 5-35 equal in males and female
large percentage in kids older than 2
What does the histology of fibrous cortical defect and fibroma look like?
fibrous cortical defect
Fibrous dysplasia presents how?
20-30s
severe reoccuring
pathologic fractures
skull, mandible, ribs, femoral neck
Which benign tumors are capable of transforming?
osteoblastoma,
fibrous dysplasia
chondroblastoma?
all rarely transform
what is the histology of fibrous dysplasia?
don’t differentiate into normal bone
how are bone tumors diagnosed?
x-ray, CT, MRI, bone scan
where do osteoclastomas present?
metaphysis
epiphysis
knee MC
uncommon primary bone tumor
What are the clinical symptoms of osteoclastomas?
- arthritic symptoms
- pathologic fractures
- aggressive
more common in women
What is the histology of osteoclastoma?
macrocytic lineage (monocyte) look like osteoclasts-multinucleated giant cell
How do osteosarcomas spread?
hematogenous spread to lungs
diagnose with bone scan and biopsy
who do osteosarcomas present in?
70% in people younger than 20
peak in elderly too
more common in men
what is an example of a malignant cartilage tumor?
chrondrosarcoma-in medullary and juxtacortical in axial or proximal appendicular
Where does a chondrosarcoma present?
proximal appendicular or axial bone
in medullary or juxtacortical
-causes osseous destruction in central area of calcification
how common in chondrosarcoma?
50% as frequent as malignant osteosarcoma
who does chondrosarcoma present in?
male more than women
people over 40 in axial and appendicular bones
medullary juxtacortical bone
What are some clinical signs of chondrosarcoma?
- painful enlarging mass
2. progressive
what does a chondrosarcoma look like on x-ray?
radiolucent lytic area
with area of central calcification(opaque)
How are chondrosarcoma’s diagnosed?
biopsy(maligant tumor)
x-ray, MRI, CT scan
What is a secondary chondrosarcoma?
a medullary and juxtacortical tumor of osseous destruction in central area of calcification
What is the course of the Chondrosarcoma?
progressive
prone to reoccur(resistant to chemo and radio)
What is an example of a malignant fibrous tumor?
histocytoma
What is the presentation of a malignant fibrous tumor(histocytoma)?
metaphysis
pelvis flat
femur, humorous, tibia(long bones)
What are the clinical signs of a histocytoma?
- in femur, tibia, humerus, pelvis
- painful enlarging mass
- pathologic fracture
middle age or elderly
What is the histology of a histocytoma?
fibroblastic (collagen producing sarcoma)
