Exam 2 - bone tumors

is osteoid osteoma benign or malignant? what is its size?

benign

<2 cm

where is osteoid osteoma commonly found? who is it more common in?

cortex of tibia/fibula

10-20 males

is osteoblastoma benign or malignant? what is its size?

benign

2+ cm

where is osteoblastoma usually found? in who?

spine

10-20 males

is osteosarcoma benign or malignant? what is the size?

malignant

fairly large

where are osteosarcomas commonly found?? in who?

metaphysis of bones of knee

10-20 males

is osteochondroma benign or malignant? relative size?

benign

fairly large

where is osteochondroma commonly found? who?

metaphysis of bones of knee

10-30 males

is enchondroma benign or malignant? relative size?

benign

fairly small

where are enchondromas located? who?

bone of hands

20-50 males

is chondrosarcoma benign or malignant? relative size?

malignant

fairly large

where are chondrosarcomas commonly found? who?

bone of shoulder and pelvic girdle

40-60 males

is Ewing Sarcoma benign or malignant? relative size?

malignant

fairly large

where is Ewing Sarcoma commonly found? who?

diaphysis of long bones (MC femur)

<20 Caucasian males

are giant cells (osteoclastoma) benign or malignant? relative size?

benign with malignant potential

large

can giant cells be aggressive

yes, locally

where are giant cells (osteoclastomas) commonly found? who?

epiphysis of long bones: knee, hip, wrist

20-40 women

is a fibrous cortical defect considered a neoplasm?

no

what is the relative size of fibrous cortical defect? where is it found?

<3 cm

metaphysis or diaphysis of lower extremity long bones

who commonly has fibrous cortical defect

children

is nonossifying fibroma considered a neoplasm? what is its relative size?

no

>3 cm

where are nonossifying fibromas commonly found? in who?

metaphysis or diaphysis of lower extremity long bones

children

is fibrous dysplasia benign or malignant?

benign proliferation of fibrous tissue and woven bone

what is the relative size of fibrous dysplasia

fairly large

but variable

where is fibrous dysplasia commonly found? in who?

ribs, calvaria, mandible, femur, humerus

children into adulthood

are primary bone tumors more common than metastasis to bone

no

radiolucent means

darker, less dense bone

are benign tumors more common than bone cancers

yes

what are the most common primary bone cancers

osteosarcoma, chondrosarcoma, ewing sarcoma

A 16 year old male patient presents to your office and the x-ray shows this (picture)? what does he have?

osteoid osteoma

someone with osteoid osteoma may complain of pain during what time of the day?

night

what is the number one most common primary bone cancer

osteosarcoma

osteosarcomas are often accompanies by ____ reactions

periosteal

Codman triangle is a type of periosteal reaction, what is happening?

lifting of the periosteum

t/f

osteosarcomas are lytic and blastic meaning they have both increased and decreased density

true

A typical osteosarcoma can be treated using ___ or ____ but a secondary osteosarcoma usually in men over 40 has a ___ response to therapy

chemotherapy, amputation, poor

are cartilage forming tumors more commonly benign or malignant

benign

what are the 3 main types of cartilage forming tumors

osteochondroma

chondroma

chondrosarcoma

which type of cartilage forming tumor is characterized by a cartilage-capped outgrowth of hylaine cartilage

osteochondroma

osteochondroma can also be called what

exostosis

85% of people with an osteochondroma will have only ____ but some people have multiple and this is known as _____

one, multiple hereditary osteochondromas

someone with multiple hereditary osteochondromas is at a higher risk for

malignant transformation

what is Ollier Disease

multiple enchondromas

are enchondromas typically symptomatic

no

what is the second most common primary bone cancer

chondrosarcoma

on X-ray, someone with a chondrosarcoma will likely have bone that has a "____" or "_____" appearance from calcification

strippled, popcorn

is a low grade or high grade chondrosarcoma more common? which is slow growing and small?

low-grade for all answers

a low grade chondrosarcoma has a ___% survival rate while a high grade has a ____% survival rate

90, 40

high grade chondrosarcomas often metastasize to what location

lungs

benign tumors from proliferation of fibroblasts and macrophages which create a well defined radiolucent lesion surrounded by thin rim of sclerosis are known as

fibrous cortical defect or nonossifying fibroma

what is the difference between fibrous cortical defect and nonossifying fibroma

size

FCD= small

NOF= big

do FCD and/or NOF persist into adulthood

no

what is unique about FCD and NOF

typically resolve on their own

fibrous dysplasia is due to failed ____ differentiation

osteoblast

ALL fibrous dysplasia cases are from a spontaneous ___ mutation

GNAS

monostotic fibrous dysplasia involves how many bones

one

polyostotic fibrous dysplasia involves how many bones

multiple

polyostotic fibrous dysplasia + cafe-au-lait spots and endocrinopathy signify what syndrome

McCune-Albright syndrome

which type of fibrous dysplasia is most common

monostotic

which type of fibrous dysplasia is likely to progress into adulthood

polyostotic

what is the second most common pediatric bone cancer

ewing sarcoma

which type of bone cancer has an onion skinning like appearance

ewing sarcoma

Ewing sarcoma involve undifferentiation of ___ ____ cells

small round

Giant cell tumor of bone (osteoclastoma) promote ____ differentiation

osteoclast

giant cell tumors of the bone often cause what appearance of bone

soap bubble

what is the most common site of metastasis to bone

spine

sarcomas travel in the ___ and carcinomas travel in the ____

blood, lymphatics

when cancer metastasized to bone, what structure of the bone does it commonly stick itself in?

red marrow

lytic= ___ density

blastic = ___ density

decrease

increase

bony metastasis from the prostate in an adult is usually

blastic

bony metastasis from breast in an adult is usually

lytic

bony metastasis from lungs in adult is usually

mixed

what are major red flags that can lead to metastatic bone cancer

over 50, history of cancer, cachexia

t/f

True neoplasms are more common than tumor-like lesions

false

a small cyst made of degenerative connective tissue found in the wrist is most likely a

ganglionic cyst

what is the most common soft tissue tumor

lipoma

the most common location for soft tissue tumors is where

deep thigh tissue

a teenage boy presents to your office after suffering a shoulder injury in football. He has a hard, painless mass that he wants checked out. What is he likely presenting?

myositis ossificans

a benign tumor of fibroblasts that is invasive is known as

fibromatoses

Deep fibromatoses are more common in ___ in the ___ region

females, abdominal

Dupuytren Contracture is a characteristic of superficial fibromatoses and is more common in who

older males of European descent

what is the name of a malignant tumor of fibroblasts that has a herringbone histology

fibrosarcoma

where do malignant tumors of fibroblasts originate

fibrous tissue

what is the most common pediatric soft tissue sarcoma

rhabdomyosarcoma

Leiomyomas are benign tumors of smooth muscle in what area

uterus

leiomyosarcomas are malignant smooth muscle tumors most commonly found in ___ specifically in the ____ and ____

adult female

uterus and IVC

synovial sarcoma is a soft tissue cancer most common between the ages of ____ and it most commonly occurs in the ___

20-40

knee