Bone tumors and tumor-like lesions

Bone tumors and tumor-like lesions (3)

1. Osteosarcoma

2. Chondrosarcoma

3. Ewing Sarcoma

Osteosarcoma Pathogenesis

Tumor fills the bone and forms a soft tissue mass on both sides of the bone

What bones does Osteosarcoma Typically Take Place (3)

1. Proximal tibia

2. Distal femur

3. Proximal humorous

Osteosarcoma Mutations (2)

RB, TP53

Osteosarcoma Histology (2)(1)

• Primitive trabeculae (Osteoid or Immature bone)

  • Thought to arise from primitive bone-forming cells

• Hyperchromatic nuclei

Osteosarcoma Clinical presentation (4)

1. Chronic bone pain

2. May be palpable mass

3. Soft tissue extension

4. More radio dense

Osteosarcoma Another radiologic feature

Codman triangle

How does the Codman Triangle Occur (2)

1. Periosteum lifted off

2. Periosteal reaction (rim of reactive new subperiosteal bone)

Chondrosarcoma Commonality

Most common = “conventional type” 90%

Chondrosarcoma Produces

hyaline cartilage

Chondrosarcoma Age

greater than 40

Chondrosarcoma Location

axial skeleton (pelvis, ribs, shoulders)

Chondrosarcoma can be secondary to

secondary to preexisting enchondroma or osteochondroma

Chondrosarcoma Tumor Grade and Prognosis (3)

• Vary from low grade →

• Slow growing to high grade with high metastatic potential

• Poor prognosis

Chondrosarcoma Symptoms

• Local swelling and pain

• Pathologic fracture as tumor grows

Ewing Sarcoma Age

80% are younger than 20

Ewing Sarcoma Origin

Cell of origin not known. May be mesenchymal stem cells or primitive neuroectodermal cells

Ewing Sarcoma Bones of Origin (2)

• Most often in diaphysis of long bones and bones of the pelvis

• 20% are extraskeletal

Ewing sarcoma Genetic Mutation (3)

• Translocation between chromosomes 11 and 22

• FLI1 gene

• EWSR1 gene

Ewing Sarcoma Gross morphology

Irregular tumor mass breaking through the bone cortex

Ewing Sarcoma Radiology

Ewing Sarcoma Histology

• Sheets of small, round cells

• Hyperchromatic nuclei

• Little cytoplasm

Ewing Sarcoma Histology - This is a tumor that was isolated from bone. What type of tissue is missing?

No bone and cartilage

Ewing Sarcoma Symptoms

• Painful large masses

• Tender, warm, swollen

Osteosarcoma Summary (3)

• Bony Growth

• Periosteal Reaction

• Long bones, near joints

Chondrosarcoma Summary (2)

• Cartilaginous Growth (Hyaline)

• Axial Skeleton

Ewing Sarcoma Summary (5)

• Unknown origin

• Irregular tumor breaks through cortex

• Long bones and pelvis

• Periosteal Reaction

• Genetic component