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69 Cards in this Set

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Where do primary malignant tumors start?
in bone
Ewing's Sarcoma usually affects which part of bone?
diaphysis
Osteosarcoma usually affects which part of bone?
metaphysis
Metastatic malignant tumors are almost always from what?
a soft tissue primary tumor that travels to bone
Benign or malignant?

-single lesion
benign
Benign or malignant?

-multiple lesions
malignant
Benign or malignant?

-a border with a narrow zone of transition
most likely benign
Benign or malignant?

-a border with a wide zone of transition
most likely malignant
Tumors can be found in which 3 sites of a bone?
1) epiphysis

2) metaphysis

3) diaphysis
a tumor that is off center is called?
eccentric (only 1 cortex is affected)
a tumor extending off the cortex of bone is called?
exostosis
Where would you find a cortical tumore?
cortex of bone
Example of an eccentric tumor?
aneurysmal bone cyst
Example of a centralized tumor?
enchondroma
A tumor centered in the marrow of bone is called?
centralized
Benign or malignant?

-intact cortex
benign
Benign or malignant?

-broken cortex
malignant
Name 5 types of aggressive periosteal reactions.
1) cumulous cloud
2) solid (thickening)
3) laminated (onion skin)
4) spiculated (sunray or sunburst)
5) Codman's triangle
What does the outer layer of the periosteum of bone consist of?
blood vessels
What is the inner layer of the periosteum of bone called?
cambium
What occurs in the inner layer of the periosteum?
osteoblastic and osteoclastic activity
Type of periosteal response with Ewing's Sarcoma?
laminated (onion skin)
Type of periosteal response with osteosarcoma?
spiculated
Age of skeletal maturity?
25 years old
What happens with periosteal response after skeletal maturity?
it decreases
Periosteal reactions can occur in patients up to age ____.
25
Are periosteal rxns more common with primary tumors or metastasis?
Primary tumors.

Rare in metastasis in the absence of a pathological fx.
Soft tissue mass is most commonly seen with which type of tumors?
primary
a well-defined area of radiolucency used only to describe a radiolucent lesion is called?
geographic lesion

>2.5cm in diameter
>50% of the shaft
Name the types of aggressive tumor destruction.
1) moth-eaten
2) permeative

-can be used interchangeably

-aka = mottled
areas of destruction with ragged borders (large, multiple areas with radiolucency)
moth-eaten
ill-defined areas thru marrow space (small, multiple areas with radiolucency)
permeative
Which type of tumors are contained?
benign
Which type of tumors usually have a frank extension thru destroyed periosteum into soft tissues?
malignant
Most common malignant tumor of the skeleton?
metastasis
What is the most life-threatening complication of any malignancy?
metastasis
Age group of metastasis?
over age 40
Metastasis in <5 year olds is called?
neuroblastoma
Metastasis in 10-20 year olds is called?
Ewing's Sarcoma & Osteosarcoma
Metastasis in >20 year olds is called?
Hodgkin's lymphoma
Metastasis is more common in men or women?
men
What are the classic signs of metastasis?
1) weight loss

2) pathologic fx

3) pain that is worst at night

4) intractible pain (no position will relieve)
Routes of extension of metastasis?
1) direct extension

2) lymphatic channels

3) hematogenous dissemination
What is the most common pathway for metastasis?
hematogeous dissemination
(thru bloodstream)
Name the route of metastatic extension:

-contiguous source
-site directly adjacent to another tumor
direct extension
Where are lymphatic channels not found?
bone marrow
Name 3 types of metastatic lesions.
1) lytic lesions

2) blastic lesions

3) blow-out metastasis
What causes lytic lesions?
-occur as a result of pressure erosion from the medullary tumor deposits

-unrelated to osteoclastic activity
type of metastatic lesion where destruction exceeds repair & radiolucent areas appear as holes in the bone?
lytic lesions
type of metastatic lesion where malignant cells proliferate faste than bone cells?
lytic lesions
Most common lytic metastatic lesion in males?
lung cancer
Most common lytic metastatic lesion in females?
breast cancer
Most common blastic metastatic lesion in males?
prostate cancer
Most common blastic metastatic lesion in females?
breast cancer
What is the most common types of metastatic lesions?
lytic lesions
type of metastatic lesion with reactive repair response of local osteoid tissue to presence of tumor?
blastic lesions
type of metastatic lesion where tumor cells replace bone at a rate that allows the body to wall off the tumor cells with new bone around the abnormal cells?
blastic lesions
type of metastatic lesion that shows increase density on radiograph?
blastc lesions
Blastic lesions show increased density on radiographs called
multiple snowball appearance
What type of metastatic lesion has the best prognosis?
blastic lesions
Mixed metastatic lesions consist of what 2 types of lesions?
1) lytic
2) blastic
Which 3 carcinomas have blow-out metastasis?
1) thyroid

2) lung

3) kidney
Blow-out metastasis commonly affects which part of the skeleton?
pelvis
Which type of metastatic lesion has a bubbly, expansile appearance?
blow-out metastasis
Name 2 ddx for blow-out metastasis.
1) solitary plasmacytoma

2) GCT
A long lesion >6cm often represents what type of tumor?
primary tumor
What is the gold standard for diagnosis primary cell type tumors?
biopsy
What percentage of loss of bone density is needed before metastasis is readily detected on x-ray?
30-50%
What type of imaging is useful for localizing biopsy sites?
CT scan