Part 13 Flashcards
cause of multiple myeloma
malignant proliferation of plasma cells
location of multiple myeloma
vertebra (T&L)
pelvis, skull, ribs
clavicle, scapula
femur, humerus
age of multiple myeloma
50-80
males
findings of multiple myeloma
circumscribed osteolytic lesions bone scans may be normal MRI for marrow changes osteoporosis/osteopenia osteolytic defects osteoblastic lesions
MRI findings of multiple myeloma
diffuse low T1
isointense to increase T2
pathologic fracture
little soft tissue mass
clinical for multiple myeloma
pain unexplainable weight loss cachexia respiratory bacterial infections anemia renal disease respiratory disease deossification of bone production of abnormal serum and urinary proteins
lab results for multiple myeloma
increased ESR thrombocytopenia rouleaux formation increase serum calcium normal or increase serum P increase plama proteins hyperglobulinemia with reversed albumin to globulin ratio M spike monoclonal globulin production bence jones proteins increase uric acid >10% plasma cells in bone biopsy
treatment/prognosis of multiple myeloma
treatment often palliative
chemotherapy, radiation
hydration and ambulation
5 year survival 20%
cause of osteosarcoma
malignant tumor of undiffereniated CT which forms an osteoid
location of osteosarcoma
DISTAL FEMUR
proximal tibia
proximal humerus
metaphysis
age/gender of osteosarcoma
10-25
>60
males
findings of osteosarcoma
ill defined sclerotic/ivory lesion moth eaten, permative spiculated/sunburst periosteal reaction large soft tissue mass with tumor new bone
clinical osteosarcoma
tend to be taller than peers painful swelling (1-2months) common to have antedant history of trauma pain insidious, becomes severe and persistent minor restriction/joint motion possible limp fever may occur mets to lung common
labs for osteosarcoma
NUC (intense increase activity
MRI- clearly defines marrow involvement on T1 and soft tissue component on T2
SPECT- soft tissue exension
treatment/prognosis of osteosarcoma
amputation
multi drug chemotherapy
early pulmonary mets often present before primary lesion is found
cause of osteochondroma
primary malignant tumor of chondrogenic origin
location of osteochondroma
PROXIMAL HUMERUS PELVIS neck of femur ribs, sternum central or peripheral
age/gender of osteochondroma
40-60
~50
male
findings of osteochondroma
round area of demineralization with ill defines margins
endoseal scalloping from pressure erosion
popcorn matrix calcification
lare soft tissue mass
primary chondrosarcoma
secondary (complication of a pre-existing skeletal abnormality such as osteochondroma or enchondroma
clinical of osteochondroma
development of large soft tissue mass
late development of pain
symptoms <2 years in 75%
cause of ewing’s sarcoma
primitive primary malignant composed of tumor cells derived from CT framework of bone marrow
location of ewing’s sarcoma
long tubular bones
diaphyseal
metaphyseal
flat bone involvement
age/gender of ewing’s sarcoma
tubular bones (<20)
flat bones (>20)
male
(10-25 avg)
findings of ewing’s sarcoma
8-10cm long lesion in shaft moth eaten, permative (late findings) long zone of transition onion skin periosteal reaaction cortical saucerization
clinical of ewing’s sarcoma
soft tissue mass formation
lung mets
MC primary malignancy to mets to bone
treatment/prognosis of ewing’s sarcoma
amputation, radiation, chemo with 60-75% 5 year survival
mets to lung, bone, lymph nodes in
11-30% upon diagnosis
40-45% within 2 yeras of diangosis
MC tumor of bone
metastasis
MC primary malignant tumor of bone
multiple myeloma
2nd MC primary malignant tumor of bone
osteosarcoma
3rd MC primary malignant tumor of bone
osteochondroma
4th MC primary malignant tumor of bone
ewing’s sarcoma
MC malignant tumor in children
osteosarcoma
MC tumor in sacrum
GCT
MC tumor in hand
enchondroma
MC benign tumor of bone
osteochondroma
MC benign tumor of bone
hemangioma
MC mets
lytic
MC primary bone tumor that mets to bone
Ewing’s sarcoma
Ivory vertebra means?
Paget, blastic mets, lymphoma
