SM_230a: Neoplasia Flashcards Preview

MSK/Derm > SM_230a: Neoplasia > Flashcards

Flashcards in SM_230a: Neoplasia Deck (53)
Loading flashcards...
1

Describe classification of major bone tumors

Classification of bone tumors

  • Bone marrow: malignant (myeloma, malignant lymphoma)
  • Bone: benign (osteoma, osteoid osteoma, osteoblastoma), malignant (osteosarcoma)
  • Cartilage: benign (osteochondroma, chondroma, chondroblastoma, chondromyxoid fibroma), malignant (chondrosarcoma)

2

Describe histology of each bone component

Histology of each bone component

  • Bone: pink dense connective tissue composed of osteocytes
  • Bone marrow: adipocytes and adipose
  • Cartilage: connective tissue w/ each chondrocyte in a lacuna

3

Describe bone tumors in general

Bone tumors

  • Most commonly occur due to metastasis from other sites: usually osteolytic (punched-out lesion), prostate carcinoma is osteoblastic
  • Most common primary bone tumors are multiple myeloma and osteosarcoma
  • Primary bone tumors often more common in males (some exceptions like giant cell tumor)
  • Histology comes last because bone can exhibit limited changes

4

Benign bone tumors are ____, ____, ____, ____, ____, ____, and ____

Benign bone tumors are osteoma, osteoid osteoma, osteoblastoma, osteochondroma, chondroma, giant cell tumor of bone, and fibrous dysplasia

5

Describe osteoma

Osteoma

  • Benign solitary
  • Middle age
  • Most commonly arise on surface of facial bones
  • Slow-growing, little significance unless blocks the sinus cavity
  • Multiple osteomas associated with Gardner's syndrome

6

Describe osteoid osteoma

Osteoid osteoma

  • Small benign tumor of osteoblasts (< 2 cm)
  • Young adults < 25, more common in males
  • Nocturnal bone pain relieved by aspirin
  • Cortex of long bones (femur)
  • X-ray: zone of sclerotic lamellar bone surrounding a lucent focus (nidus): woven bone in vascular stroma
  • Surgery or radiofrequency ablation
  • Prognosis excellent (must remove nidus)

7

Osteoid osteoma is a _____ tumor of _____

Osteoid osteoma is a small benign tumor of osteoblasts (< 2cm)

8

Osteoid osteoma presents as _____ pain relieved by _____

Osteoid osteoma presents as nocturnal bone pain relieved by aspirin

9

Osteoid osteoma manifests as ____ on X-ray

Osteoid osteoma manifests as zone of sclerotic lamellar bone surrounding a lucent focus (nidus) on X-ray

 

(woven bone in lamellar stroma)

10

Osteoid osteoma is treated with ____ or ____

Osteoid osteoma is treated with surgeery or radiofrequency ablation

11

Describe the nidus in osteoid osteoma

Nidus in osteoid osteoma

  • Radiolucent central focus of woven bone with a vascular stroma, surrounding cortical bone is thickened
  • Anastomosing woven bone + osteoblastic rimming + vascular stroma

12

Contrast osteoblastoma and osteoid osteoma

Osteoblastoma and osteoid osteoma

  • Tumors of osteoblasts
  • Osteoid osteoma: < 2cm, long bone (femur), responds to NSAIDs
  • Osteoblastoma: > 2 cm, vertebrae, does not respond to NSAIDs

13

Describe osteochondroma

Osteochondroma

  • Most common benign bone tumor
  • Male < 25, after fracture or radiation
  • Bone + cartilaginous cap arise from metaphysis (growth plate)
  • Distal femur, proximal tibia
  • Prognosis: 1-2% recur, rarely can transform to chondrosarcoma

14

____ is the most common benign bone tumor

Osteochondroma is the most common benign bone tumor

15

Osteochondroma looks like an ___ on X-ray

Osteochondroma looks like an ice cream cone on X-ray

16

Osteochondroma has a _____ cap on a bony stalk continuous with the _____ of the bone

Osteochondroma has a cartilaginous cap on a bony stalk continuous with the medulla of the bone

17

Describe chondroma

Chondroma

  • Benign intramedullary cartilaginous neoplasm
  • 2nd-4th decades, males and females equally likely
  • Medulla of small bones of hands and feet
  • X-ray: well-circumscibed, lucent with cartilage matrix calcification ("arc and ring" due to enchondral bone formation at periphery of tumor nodule)
  • Observation with serial radiographs, curettage (5% recurrence rate)

18

Chondroma occurs in the medulla of ____

Chondroma occurs in the medulla of small bones of hands and feet

19

Chondroma manifests as ______ on X-ray

Chondroma manifests as well-circumscribed lucent with cartilage matrix calcification ("arc and ring" due to enchondral bone formation at periphery of tumor nodule)

20

Chondroma is managed by ____ and ____

Chondroma is managed by observation with serial radiographs and curettage

21

Describe giant cell tumor of the bone

Giant cell tumor of the bone

  • 20-40 years (skeletally mature), more common in females
  • Epiphysis of long bone: most common in distal femur/proximal tibia (knee region)
  • Radiograph: soap-bubble lytic lesion on epiphysis
  • En bloc excision preferred
  • Locally aggressive benign tumor
  • May recur

22

Giant cell tumor of bone occurs more commonly in _____ than _____

Giant cell tumor of bone occurs more commonly in females than males

23

Giant cell tumor of the bone occurs most often in the ____

Giant cell tumor of the bone occurs most often in the knee region

 

(epiphysis of long bone: most common in distal femur/proximal tibia)

24

Giant cell tumor of the boan manifests as ____ on X-ray

Giant cell tumor of the boan manifests as soap-bubble lytic lesion in epiphysis

25

Giant cell tumor of the bone is treated with ______

Giant cell tumor of the bone is treated with en bloc excision

 

(locally aggressive benign tumor, may recur)

26

Describe fibrous dysplasia

Fibrous dysplasia

  • Benign, linked to localized developmental arrest
  • All normal component of bone present but they do not differentiate into mature structures
  • Mostly in first three decades of life
  • 3 patterns
    • Single bone / monostotic (70%): femur most common
    • Multiple bone (polyostotic): 27% w/o endocrine dysfunction, 3% w/ cafe-au-lait spots + endocrinopathy (McCune-Albright syndrome)

27

Fibrous dysplasia is linked to ____

Fibrous dysplasia is linked to developmental arrest

 

(all normal components present but do not differentiate into mature structures)

28

Describe the 3 patterns of fibrous dysplasia

Fibrous dysplasia patterns

  • Signle bone (monostotic): 70%, femur most common
  • Multiple bone (polyostotic): 27% w/o endocrine dysfunction, 3% w/ cafe-au-lait spots + endocrinopathy (McCune-Albright syndrome)

29

Summarize benign bone lesions

Benign bone lesions

  • Osteoma: benign solitary, surface of facial bone, slow-growing, little clinical significance
  • Osteoid osteoma: < 2cm long, long bone (femur), responds to NSAIDs
  • Osteoblastoma: > 2 cm, vertebrae, does not respond to NSAIDs
  • Osteochondroma: most common benign lesion, male < 25, bone + cartilage cap
  • Chondroma: M=F, medulla of small bones of hands and feet
  • Giant cell tumor of bone: F>M, epiphysis of long bones, soap-bubble
  • Fibrous dysplasia: benign, linked to localized developmental arrest

30

Malignant bone tumors are ____, ____, and ____

Malignant bone tumors are osteosarcoma, chondrosarcoma, and Ewing sarcoma

Decks in MSK/Derm Class (49):