Tumors Flashcards
location of osteiod Osteoma
50% in tib/fib,
spine,
posterior elements
Age of osteiod Osteoma
2nd , 3rd decace
Clinical osteiod Osteoma
pain worst at night
relieved with salicylates 6-24 months before diagnosis
painful scoliosis
If intraarticular it may mimic JRA w/synovitis and joint effusion
Radiology findings of osteiod Osteoma
Reactive sclerosis
lucent nidus less than 1cm
may have central calcification
misleading MR
Tx for osteiod Osteoma
surgical radiofrequency ablation
Location of osteoblastoma
long bones 40% in sline
age osteoblastoma
2nd , 3rd decade
clinical findings of osteoblastoma
rarely agressive
pseudomalignant
Radiology osteoblastoma
Giant Osteiod osteoma lucent nidus greater than 1.5 cm may have multiple internal calcifications maybe expansile less reactive sclerosis than OO
Location for osteosarcoma: classic medullary
medullary metaphyseal
40% femur
>50% at knee
age of osteosarcoma: classic medullary
10-25 yo
clinical findings of osteosarcoma: classic medullary
pain months before diagnosis
Elevated alkaline phosphate
Radiology findings of osteosarcoma: classic medullary
cloud like dense bone formation
may have extraosseous mass
sunburst
speculated periosteal reactive often with codman’s triangle
tx for osteosarcoma: classic medullary
poor prognosis (30% 5 yr) if presents with skip lesion of 4 lung mets ; isolated lesion 75% 5 yr survival
location of parosteal osteosarcoma
2/3 distal femoral metaphysis
age of parosteal osteosarcoma
27 YO , 5-10 years older than medullary
female >male
clinical findings for parosteal osteosarcoma
mass w/dull aching pain
radiology findings of parosteal osteosarcoma
amoprphous
cloud of mineralization in lobulated surface mass
Tx for parosteal osteosarcoma
better prognosis than medullary 5 yr survival >90% low grade chemo not indicated Best prognosis if no medullary extension
age for periosteal osteosarcoma
diaphysis
age for periosteal osteosarcoma
same age as medullary
clinical findings for periosteal osteosarcoma
1-2% of OS
Radiology findings of periosteal osteosarcoma
rare surface lesion
Periosteal reaction
soft tissue mass
tx for periosteal osteosarcoma
slightly better prognosis than medullary
clinical findings for Telengiectatic osteosarcoma
5% of OS
Radiology findings of Telengiectatic osteosarcoma
Usually osteolytic
frequent fluid filled levels
spider web blood vessels so blood inside the bone
Tx for Telengiectatic osteosarcoma
prognosis same as classicl OS
clinical findings in osteosarcoma in paget’s dz
occurs in 1% of paget pts
rule of 1
classic finding: their hat wont fir anymore
tx for Telengiectatic osteosarcoma
poor prognosis 5 yr survival 3-8%
location of Endchondroma
50% in hands and feet
also long flat bones
age of Endchondroma
wide age range
clnical findings of Endchondroma
painless unless fx or malignant change
Ollier’s: multiple enchondromatosis
usually presents as a growth disturbance in childhoold , not inherited
30% malignant tranformation
Mafucci’s multiple enchondromas w/soft tissue hemangiomas , all pts will die of cancer
radiology findings of Endchondroma
benign, intramedullary cartilaginous lesion, geographic lesion w/punchtate calcified matriz
maycause scalloping or expansion
location of Juxtacortical chondroma
most in small tubular bones of hands & feet
age of Juxtacortical chondroma
usuallypain and swelling soft mass (50% calcify)
radiology finding of Juxtacortical chondroma
solid , benign cartilage tumor that can erode underlying bone , erosion and saucerization of underlying bone
location of chondroblastoma
Epiphysisi
age of chondroblastoma
2nd, 3rd decade
clinical findings of chondroblastoma
benign
pain and joint effusion
radiology findings of chondroblastoma
usually geographic, 50% have calcifications
location of chondromyxoid fibroma
76% in LE metaphysis
age of chondromyxoid fibroma
wide range most in 2nd decade
clinical findings of chondromyxoid fibroma
very rare (1% bone tumores) vague pain
Radiology findigns of chondromyxoid fibroma
multiloculated
geographic with sclerotic margins
no calcifications
location of Osteochondroma
metaphysis
points away from joint
age of Osteochondroma
usually adolelscence
clinical findigns of Osteochondroma
common decreased ROM malignat degenration suspect when growth afer skeletal maturity or pain ,cartilage cao > 2cm in adults ir 3 cm in children multiple hereditary ostechondromatosis, multiple exostoses autosomal dominant incomplete penetrance
Radiology findings of Osteochondroma
cartilage capped bony excrescence ( like bony exostosis )
cap may calcify
age for Bizarre parosteal osteochondromatosis (Nora’s lesion ) age
20-30s
Bizarre parosteal osteochondromatosis ( Nora’s lesion ) clinical
benign lesion but w/ high local recurrence
location for chondro sarcoma
metaphysis
age for chondro sarcoma
40
clinical chondro sarcoma
primary ( de novo)
secondary from osteochondroma enchondroma, etc
pain
Radiology chondro sarcoma l
lucent metaphyseal lesion with calcifications may have sclerotic margins
location for clear cell chondrosarcoma
epiphysis
age for clear cell chondrosarcoma
40
clinical clear cell chondrosarcoma
resembles chondroblastoma but pt is 40 yo
radiology of clear cell chondrosarcoma
dedifferentiated chondrosarcoma
both low grade and high grade tissue present
location for non ossifying fibroma
medullary
LE
arise at growth plate and migrate to diaphysis with pt growth
age of non ossifying fibroma
common 40% of children
clinical non ossifying fibroma
asymptomatic until fracture; natural hx=regresion;
jaffe-campanacci syndrome = multiple NOFs with cafe au lait spots
NF1- multile NOFs
Radiology of non ossifying fibroma
geographic
sclerotic border
DO NOT BIOPSY!!!!!
location of fibrous dysplasia
usually unilateral
clinical fibrous dysplasia
presents w/ deformity
sometimes pain secondary to fx
albright’s syndrome = cafe au lait
polyostotic FD, endocrine abnormalities eso precocious puberty
Mazabrauds’ syndrome = polyostotic FD w/ intramuscular myxomas
Radiology of fibrous dysplasia
benign firboosseous lesion of bone 25% polyostotoc usually geographic ground glass matruc can have dense areas of calcifications MR: hypointense on T1 hyperintense on T2 but frequently heterogenous enhances with gadolinium BUT may have custic non enhancing areas
ocation for osteofibrous dysplasia (ossifying fibroma )
intracortical
FD
almost always tibia
age for osteofibrous dysplasia (ossifying fibroma )
early childhood
becomes stable
clinical osteofibrous dysplasia (ossifying fibroma )
usually painless
may be related to adamantinoma
radiology of osteofibrous dysplasia (ossifying fibroma )
ground glass cortical lesion
location for fibrisarcoma & mfh
metaphysis
age for
age for fibrisarcoma & mfh
3rd-6th decade
clinical for fibrisarcoma & mfh
may arise secondary to other lesions including infarcts
radiology for fibrisarcoma & mfh
agressive lytic lesion
no matric
no periosteal rx
