benign tumors
giant cell tumor (osteoclastoma), osteochondroma
20-40 years old
giant cell tumor (osteoclastoma)
only tumor that arises from the epiphyseal end of long bones
giant cell tumor (osteoclastoma)
tumor of osteoclasts
giant cell tumor (osteoclastoma)
locally aggressive benign tumor often around the knee
giant cell tumor (osteoclastoma)
soap bubble" appearance on x-ray
giant cell tumor (osteoclastoma)
multinucleated giant cells
giant cell tumor (osteoclastoma)
most common benign tumor
osteochondroma
males <25 years old
osteochondroma
arises from lateral projection of metaphysis
osteochondroma
mature bone with cartilagenous cap
osteochondroma
rarely transforms to chondrosarcoma
osteochondroma
2nd most common primary malignant bone tumor (after multiple myeloma)
osteosarcoma (osteogenic sarcoma)
osteosarcoma (osteogenic sarcoma) age distribution
bimodal distribution: 10-20 years old (primary), >65 (secondary)
osteosarcoma (osteogenic sarcoma) predisposing factors
paget disease of bone, bone infarcts, radiation, familial retinoblastoma, Li-Fraumeni sydrome (germline P53 mutation), male
metaphysis of long bones, often around knee
osteosarcoma (osteogenic sarcoma)
codman triangle (from elevation of periosteum)
osteosarcoma (osteogenic sarcoma)
sunburst pattern on x-ray
osteosarcoma (osteogenic sarcoma)
osteosarcoma (osteogenic sarcoma) treatment
aggressive; treat with surgical en bloc resection (with limb salvage) and chemotherapy
boys <15 years old
ewing sarcoma
commonly appears in diaphysis of long bones, pelvis, scapula, and ribs
ewing sarcoma
proliferation of poorly-differentiated cells derived from neuroectoderm
ewing sarcoma
anaplastic small blue cell malignant tumor
ewing sarcoma
onion skin" appearance in bone
ewing sarcoma
extremely aggressive with early metastases, but responsive to chemotherapy
ewing sarcoma
ewing sarcoma translocation
t(11;22)
rare, malignant, cartilaginous tumor
chondrosarcoma
men 30-60 years old
chondrosarcoma
chondrosarcoma usually located
pelvis, spine, scapula, humerus, tibia, or femur
expansile glistening mass within the medullary cavity
chondrosarcoma
may actually be a hamartoma
osteochondroma