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Skeletal > Neoplastic > Flashcards

Neoplastic Flashcards

1
Q

what is the most common malignant primary bone tumor?

A

osteosarcoma

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2
Q

Where do osteosarcomas usually prsent?

A

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

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3
Q

Who is most often affected by osteosarcomas?

A

<20yo teens
peak in elderly as well
males 6x more likley

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4
Q

what is the clinical presentation of osteosarcoma?

A

painful/weak
enlarging mass
swelling

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5
Q

What gene is osteosarcoma associated with?

A

RB gene mutation

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6
Q

what type of cells make up an osteosarcoma?

A

mesenchymal

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7
Q

What does a histologic look of osteosarcoma look like?

A

stroma(sarcomatous) surrounded by new osteoid bone matrix overproduction

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8
Q

What does an x-ray of osteosarcoma look like?

A
  1. at metaphysis of long bones limited by epiphyseal plate
  2. codman’s triangle of periosteum
  3. radioopaque bone formed outside of bone
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9
Q

How do you diagnose an osteosarcoma?

A

bone scan and biopsy.

Rule out other sites or “Skipped lesion” in same bone

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10
Q

What are 3 examples of benign bone tumors?

A

osteiod osteoma
osteoblastoma
osteoma

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11
Q

How do osteiod osteomas present?

A 
response to aspirin (decrease pain)
painful
radiolucent area around netus in bone
metaphysis and diaphysis of long bones(appendicular)
mostly males
ages 5-35yo
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12
Q

How do osteoblastomas present?

A

in the posterior elements in spine

mostly males

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13
Q

How do osteomas present?

A

subchondral and endosteal bone
of face
in lamellar and woven bone

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14
Q

What are some benign cartilaginous tumors?

A

osteochondroma
chondroma
chondroblastoma(rare)

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15
Q

how do osteochondromas present?

A

in endochondral cartilage
in metaphysis of long bone -endochondral
x-ray shows mushroom forming off of metaphysis
males 20-30 years

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16
Q

what is the etiology of osteochondromas?

A

ext genes are inactive

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17
Q

what is the presentation of chondroma?

A

in hyaline cartilage(MC interoseous tumor)

20-50 yo

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18
Q

What are the benign fibrous tumors?

A

FCD
fibroma
fibrous dysplasia

19
Q

fibroma presents how?

A

fibrous cortical defect
>5cm
non-ossifying

20
Q

fibrous cortical defect presents how?

A

distal femur or distal tibia in metaphysis
age 5-35 equal in males and female
large percentage in kids older than 2

21
Q

What does the histology of fibrous cortical defect and fibroma look like?

A

fibrous cortical defect

22
Q

Fibrous dysplasia presents how?

A

20-30s
severe reoccuring
pathologic fractures
skull, mandible, ribs, femoral neck

23
Q

Which benign tumors are capable of transforming?

A

osteoblastoma,
fibrous dysplasia
chondroblastoma?
all rarely transform

24
Q

what is the histology of fibrous dysplasia?

A

don’t differentiate into normal bone

25
Q

how are bone tumors diagnosed?

A

x-ray, CT, MRI, bone scan

26
Q

where do osteoclastomas present?

A

metaphysis
epiphysis
knee MC
uncommon primary bone tumor

27
Q

What are the clinical symptoms of osteoclastomas?

A
  1. arthritic symptoms
  2. pathologic fractures
  3. aggressive
    more common in women
28
Q

What is the histology of osteoclastoma?

A 
macrocytic lineage (monocyte)
look like osteoclasts-multinucleated giant cell
29
Q

How do osteosarcomas spread?

A

hematogenous spread to lungs

diagnose with bone scan and biopsy

30
Q

who do osteosarcomas present in?

A

70% in people younger than 20
peak in elderly too
more common in men

31
Q

what is an example of a malignant cartilage tumor?

A

chrondrosarcoma-in medullary and juxtacortical in axial or proximal appendicular

32
Q

Where does a chondrosarcoma present?

A

proximal appendicular or axial bone
in medullary or juxtacortical
-causes osseous destruction in central area of calcification

33
Q

how common in chondrosarcoma?

A

50% as frequent as malignant osteosarcoma

34
Q

who does chondrosarcoma present in?

A

male more than women
people over 40 in axial and appendicular bones
medullary juxtacortical bone

35
Q

What are some clinical signs of chondrosarcoma?

A
  1. painful enlarging mass

2. progressive

36
Q

what does a chondrosarcoma look like on x-ray?

A

radiolucent lytic area

with area of central calcification(opaque)

37
Q

How are chondrosarcoma’s diagnosed?

A

biopsy(maligant tumor)

x-ray, MRI, CT scan

38
Q

What is a secondary chondrosarcoma?

A

a medullary and juxtacortical tumor of osseous destruction in central area of calcification

39
Q

What is the course of the Chondrosarcoma?

A

progressive

prone to reoccur(resistant to chemo and radio)

40
Q

What is an example of a malignant fibrous tumor?

A

histocytoma

41
Q

What is the presentation of a malignant fibrous tumor(histocytoma)?

A

metaphysis
pelvis flat
femur, humorous, tibia(long bones)

42
Q

What are the clinical signs of a histocytoma?

A
  1. in femur, tibia, humerus, pelvis
  2. painful enlarging mass
  3. pathologic fracture
    middle age or elderly
43
Q

What is the histology of a histocytoma?

A

fibroblastic (collagen producing sarcoma)

Skeletal (4 decks)

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