Quiz 2 part II Flashcards
What is another name for a bone island?
Enstoma
Describe an enostoma
Solitary, discrete area of sclerosis. Not a neoplasm!
Common locations for enostomas? Age of patient?
Pelvis, sacrum, proximal femur, basically any bone except skull
Any age, m/c adults
How fast do enstomas grow?
They don’t grow or do so very slowly!
Plain film findings of enostoma?
Ovoid or round with sharp margins that is homogenously dense.
Often has a “brush border”
Metaphysis or epiphysis
Which benign bone tumor has a clear, lytic center surrounded by sclerosis?
Osteoid Osteoma
The lytic center is called a “nidus”
How do you tell the difference between a enostoma (bone island) from osteoblastic mets?
Ultimately will have to do a bone scan, but a brush border indicates enostoma
What is a common characteristic of osteoid osteomas?
Pain! Hardly ever are discovered incidental.
Pain gets increasingly severe and is wore at night
Common age range of patients with osteoid Osteoma?
10-25
What are two benign tumors that typically cause pain?
GCT and osteoid osteoma
Where is the m/c location for osteoid osteoma?
50% in femur and tibia
20% phalanges
10% spine, mostly neural arch
Where in bone is it m/c for osteoid osteoma to form?
Cortex, although they can occur cancellous and sub periosteal bone
Plain film findings for osteoid osteoma?
Lucent nidus (>1cm) surrounded by reactive sclerosis
Treatment for osteoid osteoma?
Must remove nidus entirely or will most likely recur
What is the go to imaging for osteoid osteoma?
Plain film- can identify 75% of the time
3 causes of painful scoliosis
Osteoid osteoma
Aneurysmal bone cyst (expansile lytic lesion)
Osteoblastoma
Which 5 benign tumors cause pain?
GCT Osteoid osteoma Osteoblastoma Chondroblastoma Aneurysmal bone cyst
Which benign tumor is a sclerotic lesion found in the skull or sinuses?
Osteoma
Which benign tumor should be DDx’d against Paget’s disease?
Hemangioma
Which benign tumor should be DDx’d against osteoblastoma and brodie’s abscess?
Osteoid osteoma
Which benign tumor, if close to the axial skeleton, should be DDx’d against chondrosarcoma?
Enchondroma
What is another name for enostoma?
Bone island
Where can bone islands form?
Anywhere except the skull
Which benign tumor has a cartilagenous cap?
Osteochondroma
Which two benign tumors have a nidus?
Osteoid osteoma
Osteoblastoma
Which benign tumor is characterized as being within the cortex, small, eccentric with a sclerotic margin?
NOF/FCD
Should you refer out for a simple bone cyst?
Yes indeed
Should you refer out for an osteoma?
No, unless it is disrupting a sinus then maybe
What is the malignant potential of osteochondroma?
Single lesion 1% Multiple lesion (MHE) 20%
What is the malignancy potential for enchondroma?
Single lesion 1%
Multiple lesions 25-50%
What is the most common benign tumor of the patella?
GCT
What % of GCT are purely lytic?
60%
40% will have soap bubbly appearance
M/c locations for osteochondroma?
85% in femur, humerus or tibia
Osteochondroma and growth plate closure?
Growth should cease when plate closes
What is the m/c benign tumor of the spine?
Hemangioma
T or F: path fx are common with hemangiomas
False AF
T or F: vertebral body expansion is common with hemangiomas
False AF
Hemangiomas in soft tissue usually contain _______
Phelobiths
What is Gardners syndrome (triad) ?
Multiple osteomas
Colonic polyps
Soft tissue fibromas
3 DDx for enostoma?
Osteoblastic mets
Osteoid osteoma
Osteoma
M/c location for osteoblastoma?
40% are in neural arch of spine
30% long bone metaph, diaph
30% hands, feet, skull, face
Which painful benign bone tumor is relieved by aspirin?
Osteoid osteoma
Are osteobalstomas mostly lytic or blastic?
Lytic!
What is the 2nd most common benign tumor?
Enchondroma
Most common location for enchondroma?
50% Phalanges (hands and feet)
50% femur, tibia, humerus, ribs
Enchondroma appearance?
Geographic Expansile Thinned cortex with scalloping Most are central Calcification in 50% No periosteal reaction, no ST mass
What is Ollier’s disease?
Multiple enchondromatosis
What is Maffucci’s syndrome?
Multiple enchondromatosis with ST hemangiomas (phleboliths), malignant transformation up to 25%
Chondroblastoma and growth plate closure
Chondroblastomas are usually seen before growth plate closure
Location of chondroblastoma?
Epiphyseal or apophyseal
Which two tumors can be found in the epiphysis?
GCT
Chondroblastoma
One main plain film finding that is different between GCT and chondroblastoma?
Chondroblastoma have calcifications 50% of the time. GCT do not.
Most common location for Chondromyxoid fibroma
50% in tibia
Location difference between FCD and NOF?
FCD stays in cortex
NOF extends into medullary cavity
T or F: NOF is more likely to be found in a 15 year old than FCD?
True AF
Most common location for NOF/FCD?
90% in tibia or fibula
Most common location for simple bone cyst?
75% in proximal humerus or femur
Treatment for simple bone cyst?
Surgery d/t high fracture rate
Primary symptom of aneurysmal bone cyst?
Acute onset of pain with rapid increase in severity
What is the most common benign tumor of the clavicle?
ABC
What is the only benign tumor to cross the growth plate?
ABC
What is the rarest primary bone tumor? Characteristics?
Intraosseous lipoma
Lytic, geographic, sclerotic border
