Tumor Chart

Question 1

B

5-20 yo, F>M

8-10 cm

metaphysis Proximal long bones, flat (pelvis), not center
Expanding, fast growing, MAY CROSS GROWTH PLATE

Lucent, thin ring (thining cortex), periosteal rxn., bubbles,

Answer 1

Aneurysmal Bone Cyst (ABC)

Question 2

Blood-filled, pain (worsens while walking), swelling

Can see fluid level on MRI, usually post- traumatic, common in clavicle

Answer 2

Aneurysmal Bone Cyst (ABC)

Question 3

B

> 1 cm (nidus)

distal long

lucent

Aspirin relieves pain, pain worst at night, no vascular blush

Answer 3

Brodie’s Abscess (osteoid osteoma)

Question 4

B 10-25

males

1–6 cm

epiph of distal femur, prox. Femur, prox tibia, Apophyseal locations

oval

lucent, reactive bone margin, scalloping, speckled, marginal sclerotic rim, matrix calcification

Answer 4

Chondroblastoma (Codman’s Tumor)

Question 5

like giant cell tumor 4 adult, MC tumor of patella

MC Tumor of the patella

Answer 5

Chondroblastoma (Codman’s Tumor)

Question 6

B

10-30 yo; 50- 70 yo males
metaphysis of proximal Tibia (around knee) - M/C site

oval

lucent, defined, endosteal scalloped cortex, NO calcifications, Soap bubbles

pain and swelling

Answer 6

Condromyxoid Fibroma

Question 7

B → M

10-30, M=F

central metaphysis, hands and feet (50%), wrists

long and oval

Lucent, sclerotic ring, endosteal scallop, Speckled/punct ate calcifications, epidermal inclusion cyst

Answer 7

Enchondroma

Question 8

Painless (sudden onset of pain = malignant transformation to Chondrosarcoma)

MC hand tumor (remove by hand surgeon); multiple = Ollier’s; Ench + heman = Mafucci

Answer 8

Enchondroma

Question 9

B

Any

Reg: <1 cm; Giant >1 cm

epiphysis, metaphysis, NOT in skull or diaphysis

Brush border, round/oval

Compact in bone marrow

Answer 9

Enostomas (Bone Island)

Question 10

Asymptomatic

NOT on bone scan, many = osteopoikilosis

Answer 10

Enostomas (Bone Island)

Question 11

B

4-8 yo

Ribs, pelvis, sacrum, ilium, Epi-dia of long bones (m/c -
posterior medial surface of distal femur)

Lucent, Marginal sclerosis, may be multiple

Cholesterol storage diseases (Gaucher’s)

Answer 11

Fibrous Xanthomas

Question 12

B

40’s

Vertebrae, long bone, skull

Extension into epidural space

Corduroy (vert), bubbles/lace (long), sunburst (Skull)

Answer 12

Hemangioma

Question 13

Crosses jt, Cordurory Cloth Appearance (coarse vertical striations in vertebral body)

M/C benign bone tumor of the spine, seen on MRI and not seen on X-ray, found in maxilla/mandible can result in DEATH from tooth extraction, Cavernous are most common type

In Skull - mostly frontal bone; Soft tissue = Phlebolit hs

Answer 13

Hemangioma

Question 14

B

2-10 yo

Cauliflower pelvic lesions

Multiple osteochondromas, Bayonet Hand Deformity (shortening of ulna, outward bowing of radius, subluxation of radioulnar joint)

Answer 14

Hereditary Multiple Exostoses

Question 15

B

5-70 yo

2-13 cm

Metaph tib/fib, calcaneus, feet

Geographic

scalloping, lytic, sclerotic border

Answer 15

Intraosseous lipoma

Question 16

Cockade sign (dystophic calcification), ususally asymptomatic (found on accident)

M/C = calceneus , Best imaging = MRI and CT

Answer 16

Intraosseous lipoma

Question 17

B

Sled runner

enchondroma + hemangioma

Type of Encondroma (more malignant that Ollier’s)

Answer 17

Mafucci’s

Question 18

B

8-20 (most in teens); males

> 8 cm

m/c - metaphysis of distal femur or tibia, not central, no periosteal reaction

Lucent, multilocular, reactive rim of bone (sclerosis), cortical thinning, scalloped

Answer 18

Non-ossifying Fibroma

Question 19

usually asymptomatic, cortical defect

MC bone lesion; Jaffe- Campanacci syndrome

Answer 19

Non-ossifying Fibroma

Question 20

B → M (some)

10-20yo

2-10 cm

posterior Vertebral arch (m/c location), meta-dia femur, foot

geographic

lucent w/ center dense, thin reactive rim

Answer 20

Osteoblastoma

Question 21

pain (NOT at night and NOT relieved by asprin)

Looks like osteoid osteoma, SOME can become malignant

Answer 21

Osteoblastoma

Question 22

B → M (Low Grade)

10–30 male

may reach 10cm

metaphysis of long near knee; knee mc

flat or stalk (coat hanger), cauliflower cap (for large lesions)

well defined, mottled density, calcificaitons. Cortex and medullary cavity blend to host bone

Answer 22

Osteochondroma

Question 23

outgrowth, away from jt, asymptomatic unless disturbed

MC B bone tumor, stops growing after growth plate fusion, Sessile = pointing posterior of joint, Pedunculated = pointing away from joint

Answer 23

Osteochondroma

Question 24

B

10-25, boys (young)
<1 cm
met. Prox. Tibia/femur, spine, hands/feet

Nidus (round or oval) - highly vascular fibrous connective tissue

Lucent ring around dense center, sclerotic ring around Nidus

Answer 24

Osteoid Osteoma

Question 25

Aspirin relieves pain, deep ache, night pain is worst, vascular blush, limited ROM

CT and/or Bone scan (MRI will show edema), thermocoagulation for confirmation

Answer 25

Osteoid Osteoma

Question 26

B

10–20, 50’s female

<2cm

Nose, sinuses, diaph of tibia
Round, oval

uniform opaque

Answer 26

Osteoma

Question 27

NO symptoms, headaches, sinusitis, assoc. with Gardner syn.

Diff from bone island – bone scan is hot. Derives from intramembranous ossification, assosicated with Gardner’s syndrome

Answer 27

Osteoma

Question 28

B

3-14 males

proximal humerus and femur (metaphysis and diaphysis)
central, oblong

lucent (broad at metaphysis; narrow at diaphysis), no periosteal rxn, fallen leaf sign (cortex falls in)

Answer 28

Simple Bone Cyst

Question 29

Hot periphery; cold center, Fallen Fragment Sign (small detached floating bone), Hinged Fragment Sign (fragment attached at one end but opposite end moves with movement), Can have pathologic fracture, DDx = Lipoma

Answer 29

Simple Bone Cyst