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Malignant Neoplasm
Malignant Neoplasm
85
Anatomy
Professional
12/11/2012

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Cards

Term
Second most common primary malignant bone tumor
Definition
osteosarcoma
Term
Age predilection of osteosarcoma
Definition
10-25 years M:F 2:1
Term
Osteosarcoma most common presenting complaint is
Definition
painful swelling
Term
Most common sites of osteosarcoma
Definition
distal femur, proximal tibia, proximal humerus
Term
Lab finding of osteosarcoma
Definition
elevated alk phosphatase
Term
3 radiologic features of osteosarcoma
Definition
50% sclerotic; 25% lytic; 25% mixed
Term
Osteosarcoma location on a long bone is primarily
Definition
metaphysis
Term
Ostosarcoma will have a ___ periosteal response
Definition
sunburst/sunray (hair on end appearance)
Term
Bone left away response with osteosarcoma will appear as
Definition
codman's triangle
Term
Osteosarcoma will have cortical disruption with
Definition
soft tissue mass
Term
Clinically male 2:1; age 10-25 years; pain and swellingl may mimic infection (slight fever, leukocytosis, elevated ESR)
Definition
Ewing's sarcoma
Term
4th most common primary malignant tumor
Definition
Ewing's sarcoma
Term
Ewings sarcoma is a round cell tumor in the ___
Definition
diaphysis but may descend to the metaphysic
Term
Ewing's sarcoma will have a ___ zone of transition
Definition
Term
Ewing's sarcoma periosteal reaction will show
Definition
laminated or onion skin
(osteosarcoma will have sunburst or speculated)
Term
Clinically: Age 40-60; M:F 2:1; pain and swelling is the presenting complaint
Definition
chondrosarcoma
Term
3rd most common primary malignant bone tumor
Definition
chondrosarcoma
Term
Chondrosarcoma radiologically will have ___ radiolucencies with ill defined margins
Definition
round; oval
Term
Chrondrosarcoma will have a predilection for the
Definition
metaphyseal/diaphyseal
Term
Chondrosarcoma will show endosteal ___
Definition
scalloping
Term
___ calcification is seen on 2/3 of chondrosarcoma
Definition
popcorn scalloping
Term
1/3 of chondrosarcoma will show
Definition
purly lytic
Term
Chondrosarcoma will have a ____ periosteal response
Definition
laminated/sunburst
Term
Common site of chondrosarcoma
Definition
knee
Term
Older patient with metaphyseal lesion
Definition
chondrosarcoma
Term
Younger patient with metaphyseal lesion
Definition
osteosarcoma
Term
Clinical ages 4-83 years; pain and swelling; long duration of symptoms
Definition
Fibrosarcoma
Term
Primary malignant bone tumor that is rare
Definition
Fibrosarcoma
Term
Fibrosarcoma is a ___ medullary lesion
Definition
highly destructive
Term
Fibrosarcoma is a ___ lesion
Definition
lytic
Term
Fibrosarcoma is __ placed
Definition
eccentrically
Term
Largest soft tissue mass of all primary malignant tumors
Definition
fibrosarcoma
Term
Fibrosarcoma is seen in the
Definition
axilla
Term
Age: 50-70; M:F 2:1; Pain is the cardinal symptom relieved by rest and aggravated by weight bearing
Definition
multiple myeloma
Term
Most common site of multiple myeloma is
Definition
the spine
Term
The most common primary malignant bone tumor
Definition
multiple myeloma (plasma cell proliferation)
Term
Other sites of multiple myeloma other than the spine are
Definition
pelvis, skull, ribs, scapula, long bones
Term
In the labs 40% of multiple myeloma patients will show
Definition
bence jones proteinuria
Term
____ is helpful in the diagnosis of multiple myeloma
Definition
protein electrophoresis
Term
One early sign of multiple myeloma
Definition
generalized osteopenia
Term
Hallmark of multiple myeloma
Definition
punched out lesions
Term
Multiple myeloma will show vertebra ___ or wrinkled vertebrae
Definition
plana
Term
___ lesions tend to be the most uniform
Definition
raindrop skull lesions
Term
Multiple myeloma will show the pedicle sign that
Definition
the pedicles remain intact
Term
In multiple myeloma the punched out lesions may __
Definition
coalesce and become one large lesion
Term
Localized form of plasma cell proliferation
Definition
plasmacytoma
Term
Most common sites of plasmacytoma
Definition
mandible, ilium, vertebrae, ribs, proximal femur, scapula
Term
70% of plasmacytomas develop into
Definition
multiple myeloma
Term
Geographic lesion, soap bubble appearance, highly expansile appearance, with pain, older patients, holes with punched out lesion
Definition
plasmacytoma
Term
__ is the most life threatening complication of any malignancy
Definition
metastasis
Term
Most common malignant tumors of the skeleton are
Definition
metastasis (70%)
Term
80% of metastasis comes from these 4 areas
Definition
breast
prostate
lung
kidney
Term
Clinical features: Age >40; patient experiences weigh loss, cachexia, bone pain (often worse at night)
Definition
Metastasis
Term
Labs seen with metastasis
Definition
alkaline phosphatase elevation
Acid phosphatase elevation in prostatic carcinoma
Term
3 metastatic pathways of spread
Definition
hematogenous
lymphogenous
direct invasion via adjacent organ
Term
Most common form of metastatic spread
Definition
hematogenous
Term
Most common sites of metastatic spread
Definition
spine, pelvis
Term
Other sites of metastatic spread
Definition
axial skeleton, ilium, pubic rami
Term
80% of metastasis is
Definition
axial skeleton (spine, humerus, femur)
Term
Metastasis is rare
Definition
below the elbow and knees
Term
Fundamental sign of metastasis
Definition
alteration in bone density architecture: more radio opaque or radiolucent
Term
75% of metastatic spread is
Definition
osteolytic- moth eaten bone destruction
Term
15% of metastatic spread is
Definition
Osteoblastic-increased bone density
Term
10% of metastatic spread is
Definition
solitary-mixed
Term
Blown out lesions of metastatic spread are seen in
Definition
renal, thyroid
Term
Favorite sites on the spine of metastatic spread
Definition
vertebral bodies, pedicles
Term
one pedicle is destroyed by metastasis and the other will not be as bright white
Definition
one eyed pedicle sign in metastasis
Term
one pedicle is destroyed by metastasis and the other will be a brighter white
Definition
agenisis of the pedicle
Term
Blind pedicle sign
Definition
both pedicles are destroyed by metastasis
Term
Vertebra plana seen with metastasis
Definition
vertebral body is flattened due to metastasis
Term
Osteoblastic metastasis will be __ on bone scan
Definition
hot
Term
Multiple myeloma bone scan will be __
Definition
cold
Term
Most common etiology for osseous osteolytic metastasis for females
Definition
breast (80%)
Term
Most common etiology for osteolytic metastasis for males
Definition
Lung (75%)
Term
Most common etiology for osteoblastic metastasis for females
Definition
breast (10%)
Term
Most common osteoblastic metastasis for males
Definition
prostate (80%)
Term
Young patients most common etiology for osteolytic metastasis is
Definition
neuroblastoma (80%)
Term
Young patients most common etiology for osteoblastic metastasis is
Definition
hodgkins (50%)
Term
Osteoblastic metastasis to the spine in ages >50 will show up as
Definition
ivory vertebrae
Term
Osteoblastic metastasis to the spine in younger ages (20-30) will show up as
Definition
ivory vertebrae (hodgekins lymphoma)
Term
Ivory vertebrae viewed as expansile in ages greater than 50 will be
Definition
Paget's disease
Term
The most common primary malignant bone tumors in order are
Definition
multiple myeloma
osteosarcoma
chondrosarcoma
Ewings
Term
The most common malignancy is
Definition
metastasis
Term
Pathological compression fractures are
Definition
uniformly compressed vertebra
Term
Non pathological compression fx are
Definition
wedge like, posterior portion of the vertebra not compressed
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