tumors of bones and joints Flashcards
night pain and metastasis
RED FLAG
Clinical manifestation: pain, swelling, fractures, mass, metastases
diagnosis: through pe, imaging, angiography, biopsy, lab tests
treatment: observation, surgical intervention, radiation, chemotherapy
benign tumors
osteoid osteoma
osteoblastoma
osteoid osteoma
rare “reactive” benign vascular osteoblastic lesion (nidus surrounded by sclerotic tissue)
in cortex of long bones found at the end of diaphysis (not in skull)
pain relieved by NSAIDS
osteoblastoma
reactive benign bone lesion
found in spine, sacrum, flat bones
LARGER than an osteoid osteoma
do not respond to NSAIDS
can lead to functional scoliosis
males under 30
treatment for osteoblastoma
long bones: curettage –> scoop out abnormal cells
cervical spine –> embolization (present blood flow to area)
malignant tumors
osteosarcoma
chondrosarcoma
ewing’s sarcoma
chordoma
giant cell tumor
osteosarcoma
Production of osteoid by malignant, neoplastic cells which can be seen on photomicrographs (help differentiate tumor)
Make up more than half of all malignant bone tumors
Occurs in growing bones (epiphyseal plates) most often in young males
Tumors arise from primitive cells from osteoblasts of the mesenchyme and grow rapidly and are locally destructive
Codman’s triangle: develops between bone and periosteum
treatment for osteosarcoma
complete surgical removal of primary tumor and any metastases
chondrosarcoma
Slow growing neoplasm that arises spontaneously in normal bone from a malignant change in a nonmalignant lesion
Most often develop in pelvis and shoulders of middle-aged men
Second most common solid malignant tumor of bones in adults
Chondr/o = cartilage!
Develops from cells committed to cartilaginous differentiation
Classified by lesion location: central, peripheral and juxtacortical
treatment of chondrosarcoma
surgical w/ complete removal of tumor
ewing’s sarcoma
RAPID NON-osteogenic primary tumor in bones or soft tissue
Third most common primary malignant bone tumor in children-young adults
Pelvis and Les are common sites
Risk factors: Caucasian race and parental occupation
95% of tumors are derived from specific genetic translocation between chromosomes 11 and 22
Tumors are soft, viscous, with hemorrhagic necrosis
treatment for ewing’s sarcoma
chemo
radiotherapy
immunotherapy
biotherapy
chordoma
SLOW but aggressive, lack capsule and infiltrate neighboring tissues
Arise in midline of body involving the CLIVIS headaches, visual disturbances, etc.
1/3 occur in sacrum, remaining are found in C/S and L/S
Pain not relieved by NSAIDs
giant cell tumor
Locally aggressive neoplasm accounting for 5% of all primary bone tumors
Involves the epiphyseal ends of long tubular bones in skeletally mature adults
Common in Chinese people
Tumor is soft, fleshy and red-brown/yellow
Pain on WB with fractures is common
Abdominal discomfort and bowel/bladder symptoms
need bone graft to fill cavity
