Disease Of Bones-Part 4 Tumors

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DISEASE OF BONES PART 4 TUMORS

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Osteosarcoma is?

metastasis is?

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most common primary malignant bone tumor
2. common form of secondary malignant bone tumors in adults

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the prostate, breast, lung, kidney, and thyroid in that order are?

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most common forms of Cx to metastasize to bone

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bone neoplasm can be benign which include?

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ivory osteoma
osteoid osteoma
echondroma

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bone neoplasia can be malignant which include?

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osteosarcoma
chondrosarcoma
ewings sarcoma
giant cell tumor
(osteoclastoma)

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bone forming tumors are?

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ivory osteoma
osteoid osteoma
osteosarcoma

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cartilage forming tumors are?

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enchondroma
chondrosarcoma

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tumors of unknown origin are?

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ewings sarcoma
giant cell tumor (osteoclastoma)

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Ivory osteoma- rare benign bone tumor.
features are?

pathology?

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1. bones of skull(parietal, frontal) and face
2. round, sessile mass dense lamellar---> pressure, obstruction

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osteoid osteoma- small painful, benign tumor..
features include: age? sex? site?

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age: below 30
sex: 2;1 males
site: cortex of DIAPHYSIS of LONG BONES

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Pathoogy of osteoid osteoma:

NE appearance is?
2. Micro appearance?

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1. round/oval surround by sclerotic bone- 1cm size
2. thin irreg trabeculae osteoid tissue

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Clinical feature?

treatment of osteoid osteoma?

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1. severe pain
2. aspirin and resection

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Osteosarcoma is?
site?
predisposing factors?

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most common primary malignant bone tumor
2. metaphysis of long bones, around Knee!!
3. factors: Paget's disease, exp to radiation, infection, chromosome 13 mutation

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pathology of osteosarcoma?
NE appearance:
arises from undiff mesenchymal cells in?
2. erodes cortex,periosteum(new bone formation) called?

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metaphysis
2. codmans triangle- with surrounding tissue

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Grade 1 of osteosarcoma (50%) presents with?

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formation of neoplastic bone tissue(sclerotic)
bony spicules along periosteal vessels (sunray appearance)

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Grade 2 of osteosarcoma presents as?

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red, soft, no matrix (osteolytic)

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clinical features of osteosarcoma include?

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painful swelling
rapid rate of growth
pathologoc fracture

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Tx of osteosarcoma includes?

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combo of surgery, chemo, radiation- lead to 5 year survival rate of 60%

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cartilage forming tumor: Enchondroma - benign tumor of mature hyaline cartilage.

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features of enchondroma include:
age?
site?

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young adults
-small bones of hands and feet

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Pathology of enchondroma:
NE appearance presents?
micro appearance presents?

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1. encapsulated nodular mass
2. mature hyaline cartilage

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Clinical features?

Treatment?

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pain
swelling
EROSION--> FRACTURE
2. removal if nec.

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Chondrosarcoma- a malignant tumor that originates from cartilage cells

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features of chondrosarcoma include:
incidence?
age?
site?

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incidence: second to osteosarcoma
age: 4-6 decades, ave: 45 yrs
site: axial, pelvic, scapula

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Pathology of chondrosarcoma:
NE appearance ?

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large, bulky, lobulated mass
area of necrosis and calcification

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chondrosarcoma -
Grade 1 (well differentiated): presents with?

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incr number of cells
occasional mitotic figures

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Chondrosarcoma
Grade 2 presents with (poorly differentiated)

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-malignant spindle shape cells
-necrosis and hemorrhage
-scant chondroid matrix

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Spread of chondrosarcoma ?

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blood to the lung.

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Tumors of unknown origin-
Ewings sarcoma- rare, extremely malignant neoplasm of bone and soft tissue

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-

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Features of ewing sarcoma :
age?
sex?
site?

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age: children/young adults (10-30)
sex: males2;1
site; diaphysis of long bones- femur, tibia, humerus, pelvis

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Pathology of ewings sarcoma:
NE appearance?

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origin: mesenchymal cells/ endothelial cells in diaphysis
extends into: cortex--> layers of subperiosteal bone form(onion-skin pattern)
surrounds soft tissue
***fleshy mass with hemorrhage and necrosis***

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Ewings sarcoma originates in?

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the diaphysis in the long bones

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Giant cell tumor (osteoclastoma)
features include:
age?
sex?
site?

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age: 20-40
sex: slight female predominance
site: epiphysis of long bone- knee, prox humerus, distal radius

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giant cell tumors are lytic on radiography and when bone cut in half reveals?

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irreg dark red-black hemorrhagic mass in epiphyseal region

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Spread of giant cell tumors include?

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potential malignant
50% reoccur after removal
20% ext into soft tissue
10% metastasis into lung