Exam 3: Benign Tumor Review Questions

A 17 year old patient with hip pain for months, x-rays reveal cortical thickening, reactive sclerosis and a 0.5cm rounded radiolucency in the medial aspect of the intertrochanteric region on the left. What is the most likely diagnosis?

osteoid osteoma

What is the usual age range associated with a giant cell tumor?

20-40 years old

An expansile neural arch tumor in a young patient is most like a(n) _____ or ______

aneurysmal bone cyst (ABC) ; osteoblastoma

Fluid-fluid levels on an MRI associated with a geographic, eccentric metaphyseal lytic lesion would likely be associated with:

aneurysmal bone cyst (ABC)

Your 16 year old patient has a central, geographic, lytic lesion somewhat truncated in appearance measuring 5cm in length in the metaphyseal region of the proximal humerus. What is the most likely diagnosis?

simple bone cyst (SBC)

Your 16 year old patient has a painful, lytic, eccentric geographic lesion with a short zone of transition in the metaphyseal region of the proximal tibia. There is no associated soft tissue mass or periosteal reaction. The likely diagnosis is:

aneurysmal bone cyst (ABC)

What age range is typically seen with an osteoid osteoma?

10-25 years old

What is the MC benign tumor of the hand?

enchondroma

Your 17 year old patient has a painful, expansile lytic lesion in the neural arch region of L4. What is the most likely diagnosis?

aneurysmal bone cyst (ABC)

_____ is the MC reason for a one-eyed pedicle sign

lytic mets

A fibrous cortical defect or non-ossifying fibroma could be called a/an:

fibrous xanthoma

Your 30 year old male patient has a painful 7cm expansile, eccentric, geographic lytic lesion in the distal metaphyseal and epiphyseal region of his left femur. What is the most likely diagonsis?

GCT

What is osteoporosis circumscripta?

well defined geographic lytic (map like) change of the calvarium especially noted in the frontal and occipital regions which represents the lytic phase of Paget's disease in the skull

Banana fractures are associated with:

Paget's disease

Are most hemangiomas symptomatic or asymptomatic?

asymptomatic

What is the follow up for hemangiomas?

no follow up needed if asymptomatic; if symptomatic they need an MRI (especially if they have neurologic symptoms)

A "picture frame" vertebra is consistent with:

paget's disease

What is Maffucci's syndrome?

multiple enchondromas and multiple soft tissue hemangiomas

Multiple soft tissue hemangiomas are noted as _____ that are in the soft tissues outside of the pelvic basin

phleboliths

What is the differential for an ivory vertebra?

-blastic mets

-paget's disease

-lymphoma

What should be suspected in a 40 year old patient that has renewed growth of an osteochondroma and new pain, and what would be the appropriate follow up?

malignant degeneration to a chondrosarcoma; appropriate follow up would include an MRI to evaluate cartilaginous portion of the tumor

What is the MC benign tumor of the sacrum?

GCT

A painful geographic eccentric lytic lesion in the distal femoral epiphysis in a 15 year old would likely be a:

chondroblastoma

What is Ollier's Disease?

multiple enchondromas or enchondromatous

What is the MC benign tumor of the spine?

hemangioma

What is an osteoma and where is the MC location?

benign tumor arising in membranous bone found in adults; usually a dense round or oval lesion found in a paranasal sinus

A candle flame sign or blade of grass sign is associated with:

advancing edge of the lytic phase of paget's disease

Is fibrous dysplasia more often monostotic or polyostotic?

monostotic

What is McCune-Albright syndrome?

polyostotic fibrous dysplasia that presents with cafe au lait spots and endocrine dysfunction (precocious puberty)

What tumor is considered quasi-malignant?

GCT

What tumor is locally painful for weeks to years in duration, worse at night and relieved with salicylates in approximately 20-30 minutes in an 18 year old patient?

osteoid osteoma

What is the age of occurrence for an ABC?

10-30 years old

Your 31 year old male patient has a painful 10cm expansile, eccentric geographic, lytic lesion in the distal metaphyseal and epiphyseal region of his right femur. What is the most likely diagnosis?

GCT

What is a "brim sign" and what disease process is it associated with?

represents thickening of the iliopectineal line and cortical lines of the pubic bones; consistent with paget's disease of the region

What is the MC benign tumor of bone?

osteochondroma

If a 37 year old patient has new pain and new growth in a known osteochondroma, you might consider or suspect a(n) ____

chondrosarcoma; MRI is advised