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Questions and Answers
A patient presents with a painful, enlarging mass in the metaphysis of their femur. Imaging reveals a Codman triangle. Which primary bone tumor is most likely?
A patient presents with a painful, enlarging mass in the metaphysis of their femur. Imaging reveals a Codman triangle. Which primary bone tumor is most likely?
- Fibrous Dysplasia
- Chondrosarcoma
- Ewing Sarcoma
- Osteosarcoma (correct)
An adolescent male presents with bone pain. Radiographic imaging reveals an "onion skin" periosteal reaction. Which of the following genetic translocations is most likely associated with this patient's condition?
An adolescent male presents with bone pain. Radiographic imaging reveals an "onion skin" periosteal reaction. Which of the following genetic translocations is most likely associated with this patient's condition?
- t(8;14)
- t(14;18)
- t(9;22)
- t(11;22) (correct)
Which of the following characteristics is most indicative of chondrosarcoma?
Which of the following characteristics is most indicative of chondrosarcoma?
- Occurs most commonly in patients under 20 years of age
- Arises from the metaphysis of long bones
- Involves the medulla of the pelvis, proximal femur, and humerus (correct)
- Presents with pleomorphic osteoid-producing cells
A 60-year-old patient is diagnosed with chondrosarcoma. Which of the following features is most characteristic of this tumor on imaging?
A 60-year-old patient is diagnosed with chondrosarcoma. Which of the following features is most characteristic of this tumor on imaging?
Which of the following tumors consists of pleomorphic osteoid-producing cells?
Which of the following tumors consists of pleomorphic osteoid-producing cells?
What is the typical location of Ewing sarcoma?
What is the typical location of Ewing sarcoma?
Which of the following is a characteristic feature of Ewing sarcoma?
Which of the following is a characteristic feature of Ewing sarcoma?
A young patient is diagnosed with osteosarcoma. Which of the following factors in their history would be LEAST likely to be associated with an increased risk of developing this tumor?
A young patient is diagnosed with osteosarcoma. Which of the following factors in their history would be LEAST likely to be associated with an increased risk of developing this tumor?
Which of the following features differentiates Ewing sarcoma from other small blue cell tumors, such as lymphoma or chronic osteomyelitis?
Which of the following features differentiates Ewing sarcoma from other small blue cell tumors, such as lymphoma or chronic osteomyelitis?
For which primary bone tumor is surgery and chemotherapy a common treatment?
For which primary bone tumor is surgery and chemotherapy a common treatment?
Flashcards
Osteosarcoma (osteogenic sarcoma)
Osteosarcoma (osteogenic sarcoma)
Accounts for 20% of primary bone cancers, peaks in males under 20. Often found in the metaphysis of long bones.
Codman triangle
Codman triangle
Elevation of the periosteum due to the tumor's growth creating a triangle shape on x-ray.
Chondrosarcoma
Chondrosarcoma
Tumor of malignant chondrocytes, commonly found in adults over 50. Located in the medulla of the pelvis, proximal femur, and humerus.
Ewing Sarcoma
Ewing Sarcoma
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"Onion skin" periosteal reaction
"Onion skin" periosteal reaction
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Study Notes
- Primary bone tumors are further classified into malignant tumors
Osteosarcoma (osteogenic sarcoma)
- Accounts for 20% of primary bone cancers
- Peak incidence of primary tumor occurs in males younger than 20 years old
- Less common in older adults and usually secondary to predisposing factors, such as Paget disease of bone, bone infarcts, radiation, familial retinoblastoma, and Li-Fraumeni syndrome
- Located in metaphysis of long bones, often in the knee region
- Characterized by pleomorphic osteoid-producing cells (malignant osteoblasts)
- Presents as painful enlarging mass or pathologic fractures
- Codman triangle (from elevation of periosteum) or sunburst pattern is observed on x-ray
- Aggressive and usually responsive to treatment (surgery, chemotherapy) although poor prognosis for secondary tumors
Chondrosarcoma
- Most common in adults older than 50 years old
- Located in the medulla of the pelvis, proximal femur, and humerus.
- Tumor of malignant chondrocytes that is Lytic in >50% cases with intralesional calcifications, endosteal erosion, and cortex breach
Ewing Sarcoma
- Most common in White patients, generally males younger than 15 years old
- Located in the diaphysis of long bones (especially the femur), pelvic flat bones
- Characterized by anaplastic small blue cells of neuroectodermal (mesenchymal) origin that resemble lymphocytes
- Differentiated from conditions with similar morphology (e.g., lymphoma, chronic osteomyelitis) by testing for t(11;22) (fusion protein EWS-FLII)
- "Onion skin" periosteal reaction
- Aggressive with early metastases, but responsive to chemotherapy
- 11 + 22 = 33 (Patrick Ewing's jersey number)
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