Bone Tumors PDF

Non-Odontogenic Bone Tumors Evaluation of Bone Pathology Age Localiza,on Radiological findings Clinical history Pathology alone is error-prone If possible, it should be discussed in a mul,disciplinary bone council Evaluation of Bone Pathology Malignant tumors perform hematogenou...

Non-Odontogenic Bone Tumors Evaluation of Bone Pathology Age Localiza,on Radiological findings Clinical history Pathology alone is error-prone If possible, it should be discussed in a mul,disciplinary bone council Evaluation of Bone Pathology Malignant tumors perform hematogenous metastases: Lung; The presence of local spread and distant metastases instead of TNM is important Correct diagnosis and correct treatment are important: CureFage + graHing: most benign lesions CureFage + local adjunc,ve therapy: local aggressive lesions, eg. Giant Cell TM Neoadjuvant CT+ surgery: OS, Ewing CT/RT: Lymphoma, myeloma Surgery only: Low-grade OS, chondrosarcoma Bone Tumors Benign Malignant Ossifying fibroma Osteosarcoma Fibrous dysplasia Chondrosarcoma Osteoblastoma Ewing's sarcoma Osteoid osteoma Plasma cell neoplasms Central giant cell granuloma Metastases Giant cell tumor Aneurysmal bone cyst Hemangioma Langerhans cell tumor Osteoma Torus and exostosis  Ossifian Fibroma Cementing fibroma Slow - expansive, Jaw - tooth area The most common mandible premolermolar region 30-40years K>E Trabecular/spherical/cementoid bone matrix in fibrous stroma Fibrı:c displasia Fibrous tissue that causes osseous metaplasia Slow expansion, deformity Initial findings 10 and 20 years M= F Monostotic / poliostotic Craniofacial fibrous dysplasia Fibro:c Dysplasia Most often maxilla Thin irregular trabeculae in fibrous tissue: Chinese letters No osteoblasts, direct metaplastic Malignancy may develop Osteoblastoma Nare, most oHen mandible Posterior tooth area Pain Ly,c stclero,c, >1 cm Ac,ve osteoblasts, bone forma,on, giant cells Con,nues with normal bone Osteoid osteoma Rare, maxilla, mandible Nocturnal pain responds to aspirin M Craniofacial is most commonly in the jaw bones, it can be in any bone Lytic expandable mass Mononuclear cells, a large number of giant cells with many nuclei Aneurysmal bone cyst Young adults, usually M Primary or secondary It may be secondary to fibrous dysplasia, osteoblastoma, giant cell tumor, osteosarcoma Most often the mandible, then the maxilla Blood-filled cavities like a sponge that has sucked blood, reperative tissue and reactive bone around it Hemangioma Most oHen mandible, posterior fF= 2 x fM Expansion, deformity, haemorrhage Variable ly,c lesion Cavernous or capillary Langerhans cell his:ocytosis Children and young adults Localized, mul,focal, disseminated Any bone can be fM> fF Fever, pain, swelling Variable ly,c lesion Abundant eosinophils, typical his,ocyte- like cells, mul,nuclear giant cells Osteoma 20-50 years old f M= 2 x f F It can be in any bone, inside the sinuses Compact sclerotic bone density May be mature/young bone Cortical, trabecular, can be mixed Chondroma Rare, adults Most often it can be in the nasal septum and ethmoid sinus, maxilla and mandible Mature hyaline cartilage lobules Difficult to distinguish from chondrosarcoma Safe surgical margin needed Torus and exostosis Nodular protrusions from the bone surface Hereditary, 16-25% in the U.S. Torus pala,nus, torus mandibularis fM> fF Exostosis: Protrusion in the buccal part of the alveolar bone Mature cor,cal and trabecular bone Osteosarcoma 5% of all osteosarcomas are in the jaw It can occur on the background of Paget, osteomyeliEs, fibrous dysplasia, giant cell tumor, bone infarcEon M> F Average age in the jaw is 34 maxilla = mandible Most common body in the mandible, palate rare in the maxilla Surface osteosarcomas: parosteal and periosteal osteosarcoma, rare Malignant mesenchymal tumor forming osteoid matrix It can also be chondroblasEc, fibroblasEc, aneurysmal or small cell Chondrosarcoma Very rare in the jaw It is mostly in the maxillofacial region, anterior and palate region Adults and older ages Cartilage with increased cellularity according to its degree Grade I normal cartilage - like chondroma Trapped bone and infiltration Ewing’s sarcoma Children and young adults Long and flat bones Most often mandibular ramus in the jaw Very aggressive, large soft tissue mass It can metastasize to other bones Radiology can be confused with osteomyelitis Uniform round cells Burkitt’s lymphoma Kids Head and neck lymphoid ,ssue Jawbone involvement especially in young children (