Neoplastic

Question 1

what is the most common malignant primary bone tumor?

Answer 1

osteosarcoma

Question 2

Where do osteosarcomas usually prsent?

Answer 2

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

Question 3

Who is most often affected by osteosarcomas?

Answer 3

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

Question 4

what is the clinical presentation of osteosarcoma?

Answer 4

painful/weak
enlarging mass
swelling

Question 5

What gene is osteosarcoma associated with?

Answer 5

RB gene mutation

Question 6

what type of cells make up an osteosarcoma?

Answer 6

mesenchymal

Question 7

What does a histologic look of osteosarcoma look like?

Answer 7

stroma(sarcomatous) surrounded by new osteoid bone matrix overproduction

Question 8

What does an x-ray of osteosarcoma look like?

Answer 8

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

Question 9

How do you diagnose an osteosarcoma?

Answer 9

bone scan and biopsy.

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

Question 10

What are 3 examples of benign bone tumors?

Answer 10

osteiod osteoma
osteoblastoma
osteoma

Question 11

How do osteiod osteomas present?

Answer 11

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

Question 12

How do osteoblastomas present?

Answer 12

in the posterior elements in spine

mostly males

Question 13

How do osteomas present?

Answer 13

subchondral and endosteal bone
of face
in lamellar and woven bone

Question 14

What are some benign cartilaginous tumors?

Answer 14

osteochondroma
chondroma
chondroblastoma(rare)

Question 15

how do osteochondromas present?

Answer 15

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

Question 16

what is the etiology of osteochondromas?

Answer 16

ext genes are inactive

Question 17

what is the presentation of chondroma?

Answer 17

in hyaline cartilage(MC interoseous tumor)

20-50 yo

Question 18

What are the benign fibrous tumors?

Answer 18

FCD
fibroma
fibrous dysplasia

Question 19

fibroma presents how?

Answer 19

fibrous cortical defect
>5cm
non-ossifying

Question 20

fibrous cortical defect presents how?

Answer 20

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

Question 21

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

Answer 21

fibrous cortical defect

Question 22

Fibrous dysplasia presents how?

Answer 22

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

Question 23

Which benign tumors are capable of transforming?

Answer 23

osteoblastoma,
fibrous dysplasia
chondroblastoma?
all rarely transform

Question 24

what is the histology of fibrous dysplasia?

Answer 24

don’t differentiate into normal bone

Question 25

how are bone tumors diagnosed?

Answer 25

x-ray, CT, MRI, bone scan

Question 26

where do osteoclastomas present?

Answer 26

metaphysis epiphysis knee MC uncommon primary bone tumor

Question 27

What are the clinical symptoms of osteoclastomas?

Answer 27

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

Question 28

What is the histology of osteoclastoma?

Answer 28

``` macrocytic lineage (monocyte) look like osteoclasts-multinucleated giant cell ```

Question 29

How do osteosarcomas spread?

Answer 29

hematogenous spread to lungs | diagnose with bone scan and biopsy

Question 30

who do osteosarcomas present in?

Answer 30

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

Question 31

what is an example of a malignant cartilage tumor?

Answer 31

chrondrosarcoma-in medullary and juxtacortical in axial or proximal appendicular

Question 32

Where does a chondrosarcoma present?

Answer 32

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

Question 33

how common in chondrosarcoma?

Answer 33

50% as frequent as malignant osteosarcoma

Question 34

who does chondrosarcoma present in?

Answer 34

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

Question 35

What are some clinical signs of chondrosarcoma?

Answer 35

1. painful enlarging mass | 2. progressive

Question 36

what does a chondrosarcoma look like on x-ray?

Answer 36

radiolucent lytic area | with area of central calcification(opaque)

Question 37

How are chondrosarcoma's diagnosed?

Answer 37

biopsy(maligant tumor) | x-ray, MRI, CT scan

Question 38

What is a secondary chondrosarcoma?

Answer 38

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

Question 39

What is the course of the Chondrosarcoma?

Answer 39

progressive | prone to reoccur(resistant to chemo and radio)

Question 40

What is an example of a malignant fibrous tumor?

Answer 40

histocytoma

Question 41

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

Answer 41

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

Question 42

What are the clinical signs of a histocytoma?

Answer 42

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

Question 43

What is the histology of a histocytoma?

Answer 43

fibroblastic (collagen producing sarcoma)