Primary bone tumors

Question 1

giant cell tumor - age and sex

Answer 1

20-40

no sex differences

Question 2

giant cell tumor - area of the bone

Answer 2

epipheseal end of long bones

Question 3

giant cell tumor - area of the body

Answer 3

epiphesial end of ling bones –> often around knee: distal femoral and proximal tibia

Question 4

giant cells tumor is AKA

Answer 4

osteoclastoma

Question 5

giant cell tumor - histology

Answer 5

Multinucleated giant cells and stromal cells

Question 6

giant cell tumor - appearance on X-ray

Answer 6

Soap bubble

Question 7

giant cell tumor - behaviour

Answer 7

locally agressive bening tumor

May recur

Question 8

MC benign tumor of the bone

Answer 8

osteochondroma

Question 9

osteochondroma - age and sex

Answer 9

under 25 (male)

Question 10

osteochondroma consists of

Answer 10

mature bony exostosis with cartilaginous (chondroid) cap

Question 11

osteochondroma rarely transforms to

Answer 11

chondrosarcoma

Question 12

osteochondroma - area of bone

Answer 12

metaphysis

Question 13

soap bubble appearance in X-RAY - bone tumor?

Answer 13

giant cell tumor

Question 14

osteochondroma - sex

Answer 14

male

Question 15

malignant tumor of cartilage

Answer 15

chondrosarcoma

Question 16

giant cell tumor - behaviour

Answer 16

locally agressive bening tumor

May recur

Question 17

X-ray appearance of osteochondroma

Answer 17

an exostosis of the bone

Question 18

osteosarcoma - area of bone

Answer 18

metaphysis

Question 19

osteochondroma rarely transforms to

Answer 19

chondrosarcoma

Question 20

chondroma usually arises in the

Answer 20

medulla of small bones of the hands and feet (metaphysis)

Question 21

chondrosarcoma usually arises in

Answer 21

medulla of pelvis or central skeleton (metaphysis)

Question 22

osteochondroma to chondrosarcoma (frequency)

Answer 22

rare

Question 23

bening tumor of cartilage

Answer 23

Chondroma

Question 24

osteosarcoma - presents as a

Answer 24

pathologic fracture or bone pain with swelling

Question 25

MC primary malignant bone tumor

Answer 25

multiple myeloma

Question 26

osteosarcoma - age

Answer 26

bimodal distribution --> 10-20 (MC) and > 65

Question 27

osteosarcoma - predisposing factors

Answer 27

1. Paget disease 2. bone infracts 3. radiation 4. Familiar retinoblastoma 5. Li-Fraumeni syndrome (germline p53 mutation)

Question 28

osteosarcoma - area of bone

Answer 28

metaphysis

Question 29

osteosarcoma - area of the body

Answer 29

(metaphysis) often around knee (distal femoral and proximal tibia)

Question 30

osteosarcoma - malignant proliferation of

Answer 30

osteoblasts

Question 31

osteosarcoma is also called

Answer 31

osteogenic sarcoma

Question 32

behaviour of osteosarcoma

Answer 32

aggressive

Question 33

Ewing sarcoma - genetics

Answer 33

translocation t(11;22) --> fusion protein EWS-FLI 1

Question 34

osteosarcoma - treatment

Answer 34

surgical en bloc resection (with limb salvage) and chemotherapy

Question 35

osteorsarcoma - Codman triangle on x-ray is produced from

Answer 35

elevation of periosteum

Question 36

Ewing sarcoma - x ray

Answer 36

onion skin periosteal reaction in bone

Question 37

Ewing sarcoma - area of the body

Answer 37

1. long bones 2. pelvis 3. scapula 4. ribs

Question 38

Ewing sarcoma - histology

Answer 38

anaplastic smal blue cell

Question 39

Ewing sarcoma in biopsy can be confused by

Answer 39

1. lymphoma | 2. chronic osteomyelitis

Question 40

primary bone tumors - round cell lesions

Answer 40

1. Ewing sarcoma | 2. Multiple Myeloma

Question 41

Ewing sarcoma - behaviour

Answer 41

extremely aggressive wtih early metastasis (but responsive to chemotherapy)

Question 42

Ewing sarcoma - age and sex

Answer 42

boys under 15

Question 43

Ewing sarcoma protein

Answer 43

EWS-FLI 1

Question 44

primary bone tumors of epiphysis

Answer 44

Giant cell tumor

Question 45

primary bone tumors of metaphysis

Answer 45

1. osteosarcoma 2. osteochondroma 3. simple bone cyst

Question 46

primary bone tumors of dipahysis

Answer 46

1. fibrous dysplasia 2. Osteoid osteoma 3. Ewing sarcoma 4. Multiple Myeloma 5. osteoblastoma

Question 47

chondrosarcoma - frequency

Answer 47

rare

Question 48

chondrosarcoma - age and sex

Answer 48

men 30-60

Question 49

chondrosarcoma - appearance of the mass

Answer 49

expansile glistening mass with the medullary cavity

Question 50

osteoma - area of the body

Answer 50

surface of the facial bones

Question 51

osteoid osteoma is a benign tumor derived from

Answer 51

osteoblasts

Question 52

osteoid osteoma appearance

Answer 52

osteoid surrounded by a rim of reactive bone (CENTRAL NIDUS)

Question 53

osteoid osteoma - age and sex

Answer 53

males

Question 54

osteoid osteoma - area bone

Answer 54

cortex diaphysis

Question 55

osteoid osteoma - x ray

Answer 55

bony mass smaller than 2 cm with a radiolucent core

Question 56

osteoid is the

Answer 56

unmineralized, organic portion of the bone matrix that forms prior to the maturation of bone tissue

Question 57

osteoid osteoma - presentation

Answer 57

NIGHT-TIME bone pain that resolves with aspirin

Question 58

osteoclastoma - bone tumor

Answer 58

Giant cell tumor

Question 59

multinucleated giant cells - bone tumor

Answer 59

giant cell (osteoclastoma)

Question 60

anaplastic small blue cells - bone tumor

Answer 60

Ewing sarcoma

Question 61

fibrous dysplasia - area of the bone

Answer 61

diaphysis

Question 62

bone tumor with bimodal age distribution (and which ages)

Answer 62

osteosarcoma 10-20 (MC) >65

Question 63

onion skin on x ray - bone tumor

Answer 63

Ewing sarcoma

Question 64

osteoblastoma - area of the body

Answer 64

vertebrae

Question 65

osteoblastoma presents as

Answer 65

bone pain that does not respond to aspirin

Question 66

osteoblastoma vs osteoid osteoma - accoriding size

Answer 66

similar but osteoblastoma larger (>2cm)

Question 67

osteoblastoma vs osteoid osteoma on presentation

Answer 67

osteoblastoma - bone pain that does not respond to aspirin | osteoid osteoma --> bone pain that resolves with aspirin

Question 68

age and sex of - giant cell tumor, osteochondroma, osteosarcoma, Ewing sarcoma, chondrosarcoma, osteoid osteoma

Answer 68

giant cell: 20-40 (no sex differences) osteochondroma: under twenty five (male) Ewing sarcoma: boys under fifteen osteosarcoma: bimodal 10-20 (MC) and > 65 chondrosarcoma: men 30-60 osteoid osteoma: under twenty five

Question 69

osteosarcoma x-ray

Answer 69

1. Codman triangle (from elevation of periosteum) | 2. Sunburst pattern

Question 70

2 MC primary malignant bone tunors

Answer 70

1. MM | 2. osteosarcoma