Tumour Pathology Flashcards
List 4 benign bone tumours
Osteochondroma
Enchondroma
Osteoid osteoma
Chondroblastoma
State 3 features of an osteochondroma
Bony projection on external surface of bone
Capped by cartilage
Contains marrow cavity continuous with that of the main bone
Which cell is usually the origin of an osteochondroma?
Chondrocyte
Where do osteochondromas usually develop?
Near epiphysis of long bones
What is the demographic distribution of people affected by osteochondromas?
Equal M:F
Mainly young,
State 3 features of an enchondroma
Hyaline cartilage tumour
Arises in medullary cavity of bones of hands and feet
May be single or multiple
What is the demographic distribution of people affected by enchondromas?
Young adults
More common in M than F
State 4 features of an osteoid osteoma
Osteoblastic tumour
Central core of vascular osteoid
Peripheral zone of sclerotic bone
Found in femur, tibia, hands/feet, spine
What is the demographic distribution of people affected by osteoid osteomas?
Usually in children and young adults
Males affected more than females
What is the distinct clinical presentation of osteoid osteomas? [3]
Dull pain for months
Worse at night
Relieved by aspirin/NSAIDs
What is the prognosis of osteoid osteomas?
Resolves without treatment
~ 33 months
Give 3 features of a chondroblastoma
Cartilage tumour arising in bone
Can be aggressive
Found at epiphyses of long bones
What is the demographic distribution of people affected by chondroblastomas?
Affects people between 10-20
How do chondroblastomas appear on X ray?
Spherical osteolytic foci
How are chondroblastomas treated?
Curettage + adjuvant liquid nitrogen
List 3 tumours that are benign but locally aggressive
Giant cell tumour
Osteoblastoma
Chordoma
State 3 features of giant cell tumours
Originates from osteoclasts
Highly vascularised tumour
Commonly affects long bones esp around knee
What is the demographic distribution of people affected by giant cell tumours?
More women affected than men
25-40yo
How do giant cell tumours appear on Xray?
Luscent centres, opaque borders
May expand into soft tissue
State 3 features of an osteoblastoma
Solitary, self limiting tumour
Produces osteoid and bone
Common in pelvis
and metaphysis/diaphysis of long bones
How are osteoblastomas treated?
Surgical resection
- curettage
What is a chordoma
Very rare
Arises from notocord remnants
Presents in midline, often sacrum
Gelatinous, well circumscribed
What is the demographic of people commonly affected by chordomas?
Older adults; 40+
M:F is 1:2
How does a chordoma appear on Xray?
Solitary midline lesion + bony destruction
50% have focal calcifications
How are chordomas treated?
Resection difficult
Radiation therapy
Chemotherapy for late-stage disease
List 3 malignant tumour types
Osteosarcoma
Chondrosarcoma
Ewing’s sarcoma
State 3 features of osteosarcoma
COMMONEST PRIMARY MALIGNANT TUMOUR
Derived from malignant osteoblasts; form osteoid
Predisposing conditions include Paget’s (older pts)
What is the demographic of people commonly affected by osteosarcoma?
Young adults; majority
Which areas are most commonly affected by osteosarcomas?
Ends of long bones around knee
- rapid growth; mitotic activity
What is the most likely route of spread of osteosarcoma?
Haematogenous
- tumour in bone invades the highly vascularised bone marrow
How does osteosarcoma look on Xray?
Raised (Cortmans) triangle off the periosteum
-prone to path. #
What is an essential finding, on histology, of osteosarcoma?
Osteoid production
How are osteosarcomas treated?
Pre-op: chemotherapy
Surgical resection
Post-op: chemotherapy
What is a chondrosarcoma?
2nd most common primary malignant bone tumour
Malignant chondrocytes ; tumour of purely hyaline cartilage
How is a chondrosarcoma treated?
Wide surgical excision
What is Ewings sarcoma?
Highly malignant tumour
Peripheral primitive neuroectodermal tumour
Mainly in metaphysis and diaphysis of femur, tibia, humerus
Uncertain cell of origin
What is the demographic of people affected by Ewings’?
M:F is 3:2
Most common in 2nd decade
How does Ewings’ appear histologically?
MANY small round blue cells
How is Ewing’s treated?
Surgery
Radiation therapy
Chemotherapy (also post op as adjuvant)
What is an osteolytic lesion?
Punched out region of bone loss
Which types of metastatic cancers can lead to osteolytic lesions?
Thyroid
Breast
Lung (esp SCLC)
Kidney
Which cancer is most likely to cause an osteosclerotic lesion in metastatic disease?
Prostate
What is multiple myeloma?
Malignant proliferation of PLASMA CELLS in bone marrow
Appears as osteolytic lesions
- mainly in old age
What are the common consequences of multiple myeloma?
Renal failure
Destruction of axial skeleton
