Flashcards in Benign Tumors Deck (75)
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1
T/F: Bone islands typically do not appear "hot" on bone scans
TRUE
2
are composed of
cortical bone, and appear as low
signal intensity on MRI on all
pulse sequences
bone islands
3
typically appear as round-to-ovoid sclerotic intramedullary foci
bone island
4
Cortical bone that has failed to undergo medullary
resorption during the process of endochondral
ossification
Bone Island: (Enostoma)
5
– Located anywhere, except in skull – Discrete area of sclerosis in bone – Asymptomatic and clinically insignificant
Bone Island (BI): (Enostoma)
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distinguishes BI from blastic metastasis
Brush border
7
– Age 10-25 yo – Pain relieved by Aspirin – Gradual severe deep aching pain – Pain could be referred to a nearby joint – Pain worse at night – Limited ROM, painful limp, stiffness, weakness
Osteoid Osteoma
8
– Painful rigid scoliosis: usu on concave side
of curve – 50% in tibia and femur – 10% in spine affecting posterior elements
Osteoid Osteoma
9
– Usu <1.0 cm in size – Radiolucent nidus with surrounding reactive
sclerosis – Nidus may calcify
osteoid osteoma
10
Highly vascularized fibrous connective tissue
nidus (tumor)
11
T/F: May need CT & Bone Scan for spinal lesions
TRUE
12
– DDX:
• Spondylolysis
• Congenital agenesis of contralateral pedicle
• Osteoblastoma
• Blastic metastasis
• Brodie’s abscess
• Stress Fracture
• Garre’s Chronic Sclerosing Osteomyelitis
osteoid osteoma
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– DDX:
• Blastic metastasis • Osteoid osteoma • Osteoma • Osteopoikilosis
Bone Island: (Enostoma)
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• Pain is relieved by aspirin and nonsteroidal anti-
inflammatory drugs • Very high levels of prostaglandins have been found in the
lesion
Osteoid Osteoma
15
– Aspirin also relieves pain – Pain worse at night – Nidus >1.0 cm in size – No angiographic vascular blush
Brodie’s Abscess
16
Osteoid Osteoma tx:
NSAIDS until pain subsides
Thermocoagulation (92% case success)
17
An insulated SMK C-15 electrode was inserted through
the cannula into the lesion and its position confirmed by
CT imaging
THERMOCOAGULATION
18
– Peak age range 10-20 yo – Usually located in posterior neural arch of spine – Pain, that is usually not at night, and not relieved by aspirin
Osteoblastoma
19
– Painful scoliosis – 2-10 cm in size – Expansile lesion with eggshell-thin cortical margin – May be sclerotic
Osteoblastoma
20
T/F: Small percentage of osteoblastomas become malignant
TRUE
21
shows fluid in MRI: T1 or T2
T2
22
– Arises from residual islands of cartilage left in metaphysis
as physis grows away – Hands (50%) and feet
Solitary Enchondroma
23
mc location solitary enchondroma
hand
24
solitary enchondroma: Sudden onset of pain without trauma signals _______
malignant transformation
25
50% have punctate calcification due to
cartilagenous matrix
Solitary Enchondroma
26
Post trauma introduction of epidermoid tissue into bone
Inclusion cyst
27
Neuroarterial lesion in hand causing pressure erosion of tuft
Glomus tumor
28
if surgery... Replace with bone chips, or cement packing (calcium
phosphate packing)
Solitary Enchondroma
29
Enchondroma with malignant transformation to a
Chondrosarcoma
30