module 3 neoplastic

Question 1

• most common benign cartilage capped tumor, which attaches to the underlying bone by a stalk
• arises from the growth zone between the epiphysis and budiaphysis of long bones, also called the metaphysis.
• Most commonly it involves the lower femur or upper tibia and is capped by growing cartilage
• Many times are asymptomatic unless the affected long bone is traumatized, which results in a pathologic fracture of the diseased bone.
• Presents a characteristic mushroom or cauliflower-like radiopaque appearance
• CT and MRI are used in initial differentiation between an osteochondroma and a malignant lesion

Answer 1

OSTEOCHONDROMA (EXOSTOSIS)

Question 2

• a fairly rare growth most commonly located in the skull and facial bones with the frontal sinus being the most common site
• These lesions are composed of very dense, wellcircumscribe, normal bone tissue that usually projects into the orbits or paranasal sinuses
• another term associated is hyperostosis frontalis interna.

Answer 2

OSTEOMA

Question 3

• a slow-growing benign tumor composed of hyaline cartilage
• grows in the marrow space and most commonly affects the small bones of the hands and feet of individuals between the ages of 30 and 40 years
• As the well-demarcated tumor grows, it expands bone locally, causing thinning and endosteal scalloping of the cortex. This process often leads to a pathologic fracture with only minimal trauma
• Radiographically, appear as radiolucent lesions containing small, stippled calcifications
• Well circumscribed and appear as a “bubbly” lesion of the bone

Answer 3

ENCHONDROMA

Question 4

• Multiple growths termed _____, may also occur in childhood and like multiple osteochondromas may undergo malignant transformation

Answer 4

endochondromatosis (Ollier disease)

Question 5

useful in distinguishing enchondromas from chondrosarcomas

Answer 5

CT and MRI

Question 6

• a wall of fibrous tissue filled with fluid
• frequently occur in the long bones of children, most commonly in the humerus and proximal femur
• usually first noticed when the patient reports pain caused by the increased tumor growth or as a result of a pathologic fracture
• Radiographically appear radiolucent with well-defined margins from normal bone surrounding the lesion
• CT appearance is very similar to radiographs, so usually unnecessary
• MRI – low signal intensity on T1 weighted images and demonstrates septations within the cys

Answer 6

SIMPLE UNICAMERAL BONE CYST

Question 7

• Another common benign tumor of the skeletal system
• These fibrous tumors occur twice as often in males compared with females and almost always develop before the age of 30 years
• most commonly found in the femur, tibia or spine of the young adult.
• a benign bone tumor that arises from osteoblasts
• Round or oval lesion with lucent center (nidus), sometime surrounded by dense sclerotic zone; less than 1 cm
• CT is considered the definitive diagnostic modality

Answer 7

OSTEOID OSTEOMA

Question 8

• Refers to a group of tumors characterized by the presence of numerous, multinucleated, osteoclastic giant cells
• affects the sexes equally and is found in individuals between the ages of 20 to 30 years
• Anatomically this disease tends to affect the ends of epiphyses of long bones, especially the lower femur, upper tibia, and lower radius
• may be either benign or malignant
• Clinical signs and symptoms are non-specific and include pain, tenderness, an occasional palpable mass, or an occasional pathologic fracture
• characteristic radiographic appearance of multiple large bubbles separated by thin strips of bone
• MRI is used to determine intraarticular extension, soft tissue involvement, and bone marrow changes. When these results are combined with radiographic images, the accuracy is especially high

Answer 8

OSTEOCLASTOMA
(GIANT CELL TUMOR- GCT)

Question 9

• most common primary malignancy of the skeleton which arises from osteoblasts
• a highly aggressive bone forming neoplasm most often located in bone marrow
• radiographic appearance of a sunray or sunburst
• MRI is an excellent modality for demonstrating this soft tissue extension

Answer 9

OSTEOSARCOMA (OSTEOGENIC SARCOMA)

Question 10

• another primary malignant bone tumor
• occurs at a younger age than any other primary malignant bone neoplasm, usually between the ages of 5 to 15 years and rarely occurs after the age of 30 years.
• Unlike osteosarcoma, ___ arises from the medullary canal and involves the bone more diffusely, giving rise to uniform thickening of the bone.
• does not begin at the end of a long bone. It does however tend to affect the extremities and pelvis
• Clinical symptoms are non-specific and include pain and tenderness of the affected area
• Radiography, CT, and MRI are essential in establishing the diagnosis and identifying the extent of the disease

Answer 10

EWING’S SARCOMA

Question 11

• a malignant tumor of cartilaginous origin and is composed of atypical cartilage
• about half as common as osteosarcoma and comprises approximately 10% of all malignant tumors of the skeletal system
• males are three times as likely as females to develop chondrosarcoma and it is more common in older adults

Answer 11

CHONDROSARCOMA

Question 12

• most common malignant tumor of the skeleton, with secondary bone tumors of any origin far outnumbering primary bone tumors. The bones of the skeletal system that contain red bone marrow are the major bones affected by ____ disease because of their good vascularization.

Answer 12

METASTASES FROM OTHER SITES

Question 13

most common primary sites for metastatic bone cancer are

Answer 13

the breast, lung, prostate, kidney and thyroid gland with the tumor spreading via proximity, the blood stream or the lymphatic system