Presby Manual - Oncology/bone Tumors

Front 1

Locations of Bone Tumors

Back 1

Front 2

Radiographic evaluation of a bone tumor helps determine rate and aggressiveness: list some qualities of an aggressive tumor

Back 2

-moth eaten, permeative patterns of bone destruction
-cortical involvement or breakthrough
-periosteal reaction (codmans)
-large tumor > 6cm
-NO sclerotic margins
-wide zone of transition (no sharp border)
-no trabeculation (no new bone formation)


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Front 3

radiographic signs of slow or benign tumor growth

Back 3

-small tumor size, <6 cm
-rarely a periosteal reaction or cortical involvement
-usually geographic in appearance
-sclerotic margins that show a narrow zone of transition
-trabeculations present (new bone formation)

Front 4

In a 1 yo pt, what bone tumor is MC

Back 4

metastatic neuroblastoma

Front 5

In a 1-10 yo pt, what bone tumor is MC

Back 5

Ewings sarcoma - has spiculated cortical reaction located in diaphysis

Front 6

In a 10-20 yo pt, what bone tumor is MC

Back 6

aneurysmal bone cyst - fast growing so it expands into the cortex

Front 7

In a 10-30 yo pt, what bone tumor is MC

Back 7

osteosarcoma - lamellated onion skin periosteal reaction

Front 8

In a skeletally mature - 50yo pt, what bone tumor is MC

Back 8

Giant cell tumor - at the end of the bone (epiphysis)

Front 9

In a 30-60 yo pt, what bone tumor is MC

Back 9

chondrosarcoma, lymphoma, fibrosarcoma

Front 10

In a 50-80 yo pt, what bone tumor is MC

Back 10

multiple myeloma, metastasis

Front 11

what lab studies can be used for bone tumors

Back 11

-alkaline phosphatase (>85 in bone disease)
-CBC (Ca is >11 in bone neoplasm)

Front 12

what diagnostic tests can be used for bone tumors

Back 12

-bone scans (increased uptake of the nucleotide reflects osteoblastic activity)
-CT
-MRI
-blood tests (Alk Phos, CBC)

Front 13

which type of biopsy removes the entire lesion and what type of tumors is it performed on

Back 13

-excisional biopsy used for benign lesions

Front 14

which type of biopsy removes a sample only of the lesion

Back 14

-incisional biopsy used for malignant lesions

Front 15

-benign osteoblastic lesion
-well demarcated
-less then 1 cm
-zone of reactive bone formation
-night pain
-point tenderness over lesion
-common in the outside of the bone (cortex)

Back 15

-osteoid osteoma
-aspirin may relieve the symptoms

Front 16

list 11 benign bone tumors common in the distal leg and foot

Back 16

1. osteoid osteoma
2. osteoblastoma
3. enchondroma
4. osteochondroma
5. non ossifyng fibroma
6. chondromyxoid fibroma
7. aneurysmal bone cyst
8. simple bone cyst (unicameral)
9. giant cell tumor
10. fibrous dysplasia
11. chondroblastoma

Front 17

list 5 malignant bone tumors cmmon in the distal leg and foot

Back 17

1. osteosarcoma
2. chondrosarcoma
3. fibrosarcoma
4. ewings sarcoma
5. multiple myeloma

Front 18

-dull aching, localized pain NOT releived by aspirin
-MC on anterior talus
-tumor is gritty and friable

Back 18

-osteoblastoma

Front 19

-benign hyaline cartilage with speckled calcification
-growth in the medullary cavity
-seen in mets and phalanges
-metaphysis location

Back 19

Enchondroma
-multiple enchondromas is Ollier's

Front 20

-benign, slow growing mushroom shaped hyaline cartilage
-sharply pedunculated or sessile tumor

Back 20

osteochondroma

Front 21

-primary tumor that initiates an AV fistula
-pt under 30
-blow out stage

Back 21

aneurysmal bone cyst

Front 22

-long fluid filled cyst
-fallen fragment sign (piece of cortical bone falling from the cyst)

Back 22

simple bone cyst (unicameral)

Front 23

-contains multinucleated osteoclast type giant cells
-soap bubble lesions

Back 23

giant cell tumor

Front 24

-ground glass appearance
-well defined sclerotic rim
-haphazardly arranged trabecula of woven bone

Back 24

fibrous dysplasia

Front 25

-geographic lucency with spotty calcifications

Back 25

chondroblastoma

Front 26

-agressive mesynchymal tumor in which neoplastic cells produce bone matrix
-common with lung metastases
-blastic mass with permeative pattern and codmans triangle

Back 26

osteosarcoma

Front 27

-agressive mesenchymal tumor in which neoplastic cells produce bone matrix
-large mass with permeative pattern and codmans reaction

Back 27

osteosarcoma

Front 28

-produces neoplastic cartilage
-bone destruction puncuated by mottled densities

Back 28

chondrosarcoma

Front 29

Back 29

ewings sarcoma; moth eaten appearance
-common in the calcaneus and femur
-10-15 yo

Front 30

Back 30

-multiple myeloma
-40-70 yo
-oval lesions

Front 31

what are the MC sources of metastatic cancer

Back 31

-breast, lung, prostate, kidney, thyroid

Front 32

compare a benign soft tissue mass and a malignant soft tissue mass

Back 32

-benign soft tissue mass looks like derivative tissue, small, cystic filled and moveable

Front 33

list 5 common benign soft tissue tumors

Back 33

1. ganglion cyst
2. plantar fibroma
3. lipoma
4. neurofibroma
5. neurolemoma

Front 34

most common benign soft tissue tumor

Back 34

lipoma; subcut, soft, moveable mass

Front 35

subcutaneous thickening of the plantar fascia

Back 35

plantar fibroma

Front 36

what colored fluid comes out of a ganglion cyst

Back 36

straw colored fluid

Front 37

popcorn bone tumor

Back 37

enchondroma

Front 38

onion skinning tumor

Back 38

ewings sarcoma

Front 39

list the 4 radiographic clues about the growth rate of a bone lesion

Back 39

1. destructive pattern
2. size and shape
3. cortical involvement
4. periosteal reaction

Front 40

list the diff types of destructive patterns and how they relate to growth rate

Back 40

-geographic (small circles with sclerotic margins, slow growth)
-moth eaten (small lesions across an area, fast)
-permeative (small streaks in the bone, fast)

Front 41

acute osteopenia can have a permeative or moth-eaten appearance; so how does it differ from a fast growing malignancy

Back 41

-it involves multiple bones

Front 42

which type of lesion is longer (rather then wider) and fills the medullary canal bc it takes the path of least resistance

Back 42

-slow growing lesion

Front 43

which lesions penetrate or break through the cortex and invade the soft tissue

Back 43

-agressive lesion

Front 44

which is more agressive growth; constant periosteal reaction or interrupted periosteal reaction

Back 44

-interrupted periosteal growth

Front 45

trabeculation is only found in certain tumors; list them

Back 45

-giant cell tumor (fine trabeculation)
-aneurysmal bone cyst (horizontal fine trabecula)
-chondromyxoid fibroma(thick trabecula)
-hemangioma(radiating trabecula)
-non ossifying fibroma(soap bubble trabecula)

Front 46

name a specific continuous periosteal reaction

Back 46

-onion skin or spiculated (hair on end)
-this is still an agressive lesion, but least agressive

Front 47

name a specific interrupted periosteal reaction

Back 47

-Codmans triangle
-sunburst

Front 48

stippled or speckled matrix production

Back 48

-chondroblastic tumors (enchondroma, osteochondroma, chondroblastoma, chondrosarcoma)

Front 49

solid matrix production

Back 49

-osteblastic tumors (osteoid osteoma, osteoblastoma, osteosarcoma)

Front 50

oval, metaphyseal, blow out lesion with soap bubble trabeculation

Back 50

-ABC (aneurysmal bone cyst)