MOCE & Benign Bone Tumors

MOCE

• Multiple Myeloma

• Osteosarcoma

• Chondrosarcoma

• Ewing’s Sarcoma

AKA for multiple myeloma

Plasma cell myeloma

What will plasma cell myeloma cause an overproduction of?

IgG

What population does multiple myeloma affect?

Older population

What is the MC presenting symptom of multiple myeloma?

Bone Pain

What is the MC cause of death for plasma cell myeloma?

Bacterial Infection

What is the second MC of death for multiple myeloma?

Renal Failure

What are the two name signs that are affected by plasma cell myeloma?

Punched-out lesions and Raindrop skull

What is the hallmark finding for plasma cell myeloma?

Reversed A/G ratio

What are some of the finding that you would find in lab for plasma cell myeloma?

1. M-protein spike

2. Bence-jones proteriuria

3. Anemia

4. Hypercalcemia

5. Reversed A/G ratio (Hallmark Finding)

What is Bence-Jones Proteriuria?

A condition characterized by the presence of free light chains of immunoglobulins in the urine, often associated with plasma cell disorders like multiple myeloma.

What is M-protein spike lab findings?

Significant increase of monoclonal immunoglobulin in serum or urine, abnormal presence of abnormal clone of plasma cells.

What is reverse A/G ratio in a lab finding?

The reverse A/G ratio is a laboratory finding where the levels of albumin are lower than the levels of globulin in the serum.

What is osteosarcoma?

Tumor, bone cancer of mesenchymal cells in medullary cavity, which are long bones.

What happens to the bone with osteosarcoma?

It causes direct formation of osteoid (Blastic tumor)

What population of people does osteosarcoma affect?

Young people, especially during the growth phase.

Why is the metaphysis the MC site for x-ray for osteosarcoma?

Its where bone growth is most active which makes it a prime location for bone tumor development.

What is seen in labs with those that have osteosarcoma?

Elevated alkaline phosphatase

What is elevated alkaline phosphatase?

A biochemical marker measuring the enzyme levels in the bloodstream. It indicates increased bone turnover or liver dysfunction (Cirrhosis, hepatitis, liver cancer)

What is chondrosarcoma?

A rare malignant tumor arising from cartilage and affects the cartilaginous end plates and annulus fibrosis.

Where does chondrosarcoma most commonly affects?

Pelvis and Femur

What population of people does chondrosarcoma affect?

Older people, 40 - 60.

What are signs that show up on x-ray with chondrosarcoma? (3)

1. Endosteal scalloping inside bone

2. Mottled Calcification of tumor matrix

3. Laminated or Spiculated Periosteal Response *Onion Skin Periosteum*

What is Ewing’s Sarcoma?

Tumor of primitive stem cells, that occurs in and around the bones.

What group of people does Ewing’s Sarcoma affect?

Young people around the age of 10-20 years old.

How does Ewing’s Sarcoma like to appear?

Like an infection with redness and swelling

What are seen in x-rays with Ewing’s Sarcoma? (2)

1. Lytic & Sclerotic Lesions

2. Cortical Saucerization

What is lytic vs sclerotic?

Lytic is areas where bone is destroyed and sclerotic is where there is an increase in bone density since increase in bone growth in area

What is a name sign associated with Ewing’s sarcoma?

Onion Skin Periosteum

What is onion skin periosteum?

Laminated periosteum response

Chondrosarcoma has this response as well

What is osteochondroma?

Hereditary multiple exostosis, MANY throughout the body.

What is the AKA osteochondroma?

Exostosis

What are the characteristic of exotosis?

Painless and not destructive

What is the name sign associated with osteochondroma?

Coat hanger exotosisWhat

T/F Osteochondroma cannot degenerate to chondrosarcoma.

FALSE, it CAN degenerate to chondrosarcoma.

What is coat hanger exostosis?

Where the pedunculated exostosis is pointing up and away from joint line.

What is hemangioma?

MC primary benign tumor of axial skeleton