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56 Cards in this Set
- Front
- Back
What are soft tissues?
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tissues of the MSK that attach to and support the boney skeleton
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What are the two ways that we classify soft tissue lesions?
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-cell of origin
-cell of differentiation that the cell tries to recapitulate |
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What are examples of the common, uncommon, and rare soft tissue lesions
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lipoma
synovial sarcoma extraskeletal myxoid chondrosarcoma |
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What are examples of soft tissue tumors that occur in different age groups?
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-child: rhabdomyosarcoma
-adol: snovial sarcoma -young adult: synovial sarcoma -adult: liposarcoma |
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How do soft tissue lesions present?
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-painless
-enlarging mass -location: lower 40%, upper 20%, h/n 0%, trunk and retroperitoneum 30% |
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Superficial tumors are ________ (more/less) likely to be benign whereas deep tumors are ________ (more/less) likely to be malignant.
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more
more |
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Should you excise a lesion for biopsy yourself? What about a fine needle aspiration?
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NO and NO!!
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What are the features of differentiation?
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-cell features
-architectural pafeatures -growth patterns -antibodies to detect proteins -molecular studies |
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What are the three categories of soft tissue lesions?
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-benign
-intermediate -malignant |
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What are the features of benign, intermediate, and malignant soft tissue lesions?
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-benign: self limited, not recuring, no mets
-intermed: local aggression, not metastatic -malignant: locally aggressive, recurs locally |
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What are the types of fibroblastic tumors?
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benign - fibroma
intermed - fibromatosis malignant: fibromyxoid sarcoma |
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What are the types of lipogenic tumors?
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benign - lipoma
malignant - liposarcoma |
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What are teh types of smooth muscle tumor
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benign - leiomyoma
malignant - leiomyosarcoma |
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What is a characteristic of smooth muscle tumors?
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they tend to grow in fasciles where bundles grow at 90 degrees
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What are the types of skeletal muscle tumors?
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benign - rhabdomyoma
malignant - rhabdomyosarcoma |
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What is a characteristic of skeleteal muscle tumors?
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cross-striations
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What are the types of vascular tumors?
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benign - hemangioma
intermed - hemangioendothelioma malignant - angiosarcoma |
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What are the types of peripheral nerve sheath tumors?
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benign - neurofibroma, schwannoma, perineurioma
malignant - malignant peripheral nerve sheath tumor |
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What does a neurofibroma consist of?
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a mixture of axon, Schwann, and perineurial cells
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What are the types of cartilaginous tumors?
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benign - chondroma
malignant - mesenchymal chondrosarcoma |
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What are the types of osseous tumors?
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benign - myositis ossificans
malignant - osteosarcoma of soft tissue |
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What are the types of tumors of uncertain origin?
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synovial sarcoma
Ewing sarcoma epithelioid sarcoma alveolar soft part sarcoma clear cell sarcoma |
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How are bone tumors classified?
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based on the normal tissues they are trying to recapitulate
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What are the types of chondrogenic tumors?
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benign - osteochondroma, chondroma,
malignant - chondrosarcoma |
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What are the types of osteogenic tumors?
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benign - osteoid osteoma, osteoblastoma
malignant - osteosarcoma |
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What are the types of fibrogenic tumors?
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benign - non-ossifying fibroma, fibrous dysplaia
malignant - malignant fibrous histiocytoma of bone |
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What are the types of osteo tumors of unknown origin?
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benign - giant cell, unicameral, anuerysmal
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What are the neuroectodermal tumors?
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malignant - Ewing sarcoma
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What are the notochordal tumors?
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malignant - chordoma
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Where can Ewing sarcoma, lymphoma and myeloma arise in a bone?
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anywhere
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Where can Giant cell, clear cell, and chondrosarcoma arise in a bone?
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-at the epiphysis
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If a kid or adolescent presents with a bone tumor, is it likely to be primary or metastatic?
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more likely to be a primary bone tumor
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In older adults, is it like to be a primary tumor?
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No. It is likely metastatic or hematopoetic
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What is the clinical presentation of bone tumors?
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-found incidentally
-pain -mass -fracture |
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What is the characteristic of pain in bone tumors?
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-not associated with trauma
-persistent -increasing intensity |
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What can the masses in bone tumors do?
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-they expand the bone
-they involve the surface of the bone -they infiltrate the cortex and surrounding soft tissue |
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What are the red flags for bone tumors?
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-pain: nocturnal, persistent, increasing intensity
-enlarging mass -fracture |
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T/F: benign and malignant tumors present with similar symptoms
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true
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What is the investigation for bone tumors?
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-xray: but can be falsely negative
-bone scan: most sensitive but can be false positive -CT and MR: good sensitive and specific |
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How does bone react to neoplasm?
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-resorption (lysis - hole)
-formation (blastic or sclerotic) -mixed lysis and sclerosis (bone remodelling induced by tumor) |
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What are some benign features of bone tumor on xray?
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-circumscribed margins
-sclerotic rim of reactive bone -expansile growth pattern |
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What are some malignant features of bone tumor on xray?
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-poorly circumscribed
-multiple bones -elevated periosteum |
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What is an osteoma?
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-a benign bone forming lesion
-common in head and neck area |
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What is an osteoid osteoma?
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-small (< 2 cm) benign solitary bone forming lesion characterized by pain that is worse at night and is relieved by aspirin
-mostly in young people |
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What is osteoblastoma?
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-benign
-larger (> 2 cm) lesion -pain not relieved by aspirin -likes the axial skeleton |
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What is an osteosarcoma?
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-malignant
-produces osteoid (collagen), bone or both -can be primary or secondary -pulmonary metastases |
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Where does osteosarcoma tend to occur?
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-metaphysis of long bone in youngsters
-flat bones and long bones of adults |
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What is the main prognostic indicator for osteosarcoma?
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-more than 90% of tumor necrosis following treatment
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What is osteochondroma?
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-protrudes from surface of bone
-characterized by a cartilageous cap with a bony stalk |
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What is enchondroma?
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-benign cartilaginous tumor located within the bone
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What is chondroblastoma
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benign cartilaginous tumor
-chicken wire calcification |
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What is chondromyxoid fibroma?
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benign lesion that is chondroid, myxoid, and fibroma like
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Fibrous dysplasia on histology... what does it look like?
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chinese writing characters
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What is Ewing sarcoma?
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-small round blue cell tumor
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What is the clinical presentation of Ewing sarcoma?
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-pain
-mass (warm, tender) -fracture -systemic findings: fever, elev ESR, anemia, leukocytosis -it 'mimics infection'!! -sheets of uniform, small, round blue cells |
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What tumors metastasize to bone in adults?
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prostate, breast, lung, kidney (mostly!)
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