Pathology of Bone Tumors

Question 1

Giant Cell Tumors are found where?

Answer 1

EPIPHYSIS

Question 2

What two bone tumors are normally found in the METAPHYSIS?

Answer 2

Chondrosarcoma

Osteosarcoma

Question 3

EWING SARCOMA are found where?

Answer 3

DIAPHYSIS (ALWAYS)

Question 4

rare benign tumor of mature bone

usually asymptomatic

Answer 4

Osteoma

Question 5

Age: 40-50 yo

Site: cortical bones of skull and face

X-ray: well-delimited nodule

Answer 5

Osteoma

Prognosis:  
    good (simple excision)
slow-growing
not invasive
no malignant transformation

Question 6

Bone tumor that presents with PAINFUL LESIONS

central area of tumor (nidus)

Answer 6

Osteoid osteoma & Osteoblastoma

• osteoblastoma = “giant osteoid osteoma

Question 7

pain is relieved by ______ in osteoid osteoma where it is not in osteoblastoma

Answer 7

aspirin

Question 8

20 year old presents with pain around the knee. What benign tumor could it be?

Answer 8

Osteoid Osteoma

Question 9

Age:teens- twenties

Site: vertebral column, other

Size: > 2 cm

X-ray: radiolucent nidus, less (or no) sclerotic rim

Prognosis: good, if totally excised

Answer 9

Osteoblastoma

Question 10

most common 1° malignant tumor of bone (20% of 1° bone malignancies); M:F = 1.6:1

Answer 10

Osteosarcoma

Question 11

If you dont see ____ you can not call it an osteosarcoma.

Answer 11

Osteoid

Question 12

malignant mesenchymal tumor; neoplastic cells produce osteoid (unmineralized bone matrix); sometimes makes cartilage

Answer 12

Osteosarcoma

usually arises in metaphysis of long bones of extremities

Paget disease, chronic osteomyelitis, prior irradiation, bone infarcts, fibrous dysplasia

Question 13

aggressive !!!

20% with pulmonary mets at time of diagnosis

Answer 13

Osteosarcoma

grows so rapidly that it destroys other bone ( PAINFUL)

Question 14

How do you diagnose osteosarcoma?

Answer 14

Need to see Osteoid

Question 15

Elevation of periosteum
to produce an angle between
surface of involved bone

Answer 15

Osteosarcoma – Codman Triangle

Question 16

Mushroom with a stalk

Age (young)
Site: Metaphysis
Prognosis: Good if solitary but if multiple you have increased risk of developing chondroSARCOMA

Answer 16

Osteochondroma (Cartialge forming)

Question 17

Bening tumors of hyaline cartilage; well circomsribed
- Most common in hands an feet

In medullary –>_______

Answer 17

Chondroma

Enchondromas

Question 18

Most common intra osseous cartilage tumor

Found in metaphyses of tubular bones PARTICULARLY HANDS AND FEET

• young patient

Answer 18

Chondroma

Ollier Disease –> Multiple chondromas

Question 19

Malignant version of chondroma is chondrosarcoma which is normally located where?

Answer 19

Prognosis –> depends on grade (size are important)

Question 20

_______ is a tumor of the AXIAL skeleton

Answer 20

Chondrosarcoma

Question 21

1. Small round blue tumors

2. Primative neural tumors derived from a precursor multipotent mesenchymal stem cell ( HOMER WRITE ROSETTES)

Answer 21

1. Ewing Sarcoma

2. Primitive Neuroectodermal Tumor (PNET) ( MORE MATURE then above)

Question 22

Ewing Sarcoma (EWS)
or
Primitive NeuroEctodermal Tumor (PNET

undifferentiated

Answer 22

EWS

Question 23

Ewing Sarcoma (EWS)
or
Primitive NeuroEctodermal Tumor (PNET

neural differentiation (–> Homer Wright rosettes)

Answer 23

PNET

Question 24

found in 30 - 50% of children 4-8 yo

probably developmental defect rather than neoplasm

Answer 24

Fibrous Cortical Defect

most arise in metaphysis of distal femur & proximal tibia (most common = knee)

Resolve spontaneously

Question 25

Scalloped Margin

Answer 25

Fibrous Cortical Defect

Question 26

curvilinear spicules of immature woven bone (Chinese characters) surrounded by fibroblastic proliferation

Answer 26

Fibrous Dysplasia

Prognosis: good

Question 27

contains numerous osteoclast-like multinucleated giant cells mixed with mononuclear stromal cells

Arise in the _____

Answer 27

Giant Cell Tumor of Bone

osteoclastoma

Epiphyses of long bones
- Pain in the knee is an example

Question 28

_______tumors to bone

are at least 20 X more common than primary bone tumors.

Answer 28

Metastatic

Most metastatic lesions are osteolytic;