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MSK- bone and soft tissue tumors
ddd
62
Architecture
10th Grade
09/19/2012

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Cards

Term
bone forming tumor
Definition
osteoid osteoma
osteoblastoma
osteogenic sarcoma
Term
Marrow tumors
Definition
ewings sarcoma
myeloma
lipoma (fat elements)
Term
Low grade tumors G1
Definition
few cells- mature
much stroma
fwer than 5 mitoses
localized
Term
G2 - high grade tumor
Definition
many cells
immature
much necrosis
little stroma
more than 10 mitoses
blood metastases
Term
T-1
Definition
intracomparmental - within fascial compartment
Term
T-2
Definition
extrecompartmental
Term
T1A
Definition
low grade intracompartmental tumor
Term
T1B
Definition
low grade extracompartmental
Term
stage 3
Definition
aggressive, penetrates bone.
ANy stage with metastis.
Term
incisional biopsy
Definition
stay within compartment
Term
wide excision biopsy
Definition
removal of tumor and surrounding tissue.
used for maliganancies, usually
Term
Biopsy accuracy
Definition
open biopsy permanant section is 96%. highest
Frozen section is 80%
Term
staging soft tissue malignancies
Definition
grade, depth, size and metastasis. also bone deforming?
Term
Malignant lesion of bone
Definition
not clearly delineated

breaks through cortex
Term
Benign lesion of bone
Definition
sharp border

intact cortex - cortex can balloon out (ABC)
Term
Epiphysis bone tumors
Definition
chondroblastoma and giant cell tumor
Term
metaphysis bone tumors
Definition
chondrosarcoma, osteosarcoma and bone cysts
Term
diaphysis bone tumors
Definition
ossifying fibroma
ewings sarcoma
myeloma
Term
Pt evaluation
Definition
LABs: CBC, ESR, CRP, alkaline phos.
Imaging: XR, CT, MRI-softtissue
Term
treatment of malignant tumors
Definition
wide excision
radial resection- removing entire compartment
AMPUTATION
Term
Ganglion cyst
Definition
MC bening lesion of hand and foot
Term
giant cell tumor of tendon sheath
Definition
2nd MC lesion of hand and foot
Term
giant cell tumor of tendon sheath
Definition
golden color due to hemosiderin

Histo: multinucleated giant cells
Term
hemangioma
Definition
bluish discoloraed mass on hand
Term
Lipoma
Definition
soft and squishy
non-tender
MRI - same color as fat
transforms to liposarcoma
Term
Epidermal inclusion cyst
Definition
epidermis gets into dermal layer and proliferates

men, 3-4 decade
Term
Schwannoma
Definition
can present as CTS!
painless, volar surface, tinel sign - tap flexor retinaculum

HISTO: antoni A = palisades of tumors cells
Antoni B - minimal cell. BOTH areas will be present in lesion.
Term
Schwannoma
Definition
50% have mutation of gene "schwannomin" on chrom 22
Term
neurofibroma
Definition
tumor of fascicles of nerve
Term
neurofibroma
Definition
NF-1 - mutation of "neurofibromin" on chrom 17
NF-2 - abn chrom 22
Term
Glomus tumor
Definition
VERY painful
lesion under nail
***TRIAD of sxs:
intermittent severe pain
cold intolerance
point tenderness - VERY VERY PAINFUL
Term
Glomus tumor
Definition
excision is curative
Term
Enchondroma
Definition
MC benign bone tumor
looks like popcorn on XR, usually of long bones
Term
Enchondroma
Definition
Age10-40, pathologic frxs
90% of all bone tumors in hand
Term
Olliers disease
Definition
multiple enchondromatosis, nonhereditary

30% malignant transformation to chondrosarcoma
Term
Maffucci's
Definition
soft tissue hemangiomas plus multiple enchondromas
Term
osteochondroma
Definition
has cartilage cap, can have malignant transformation
Term
chondromyxoid fibroma
Definition
benign, soap-bubble appearance on XR
VERY RARE - <20cases
Term
osteoid osteoma
Definition
benign, lytic more frequent than sclerotic

pain relieved by ASA
Term
osetoblastoma
Definition
similar to osteoid osteoma but larger! >2cm
Term
Unicameral Bone Cyst
Definition
not really a tumor! contains fluid.
in long bones
FALLEN LEAF SIGN - bone fragment from pathologic frx floats in medulla.
Term
ABC aneurysmal bone cyst
Definition
common in hand -metacarpal>phalanx>carpus
common in spine
t(16:17) translocation
Ballooning of cortex
Term
giant cell tumor of bone
Definition
aggressive, benign (lowgrade malignant)
lytic epiphyseal lesion!!

hand lesion at higher risk for metastasis
Term
giant cell tumor of bone
Definition
surveillance is mand.
pt must be staged: bone scan, chest XR, CT
Term
giant cell tumor of bone
Definition
distal radius lesion is more malignant - 25% metastasize to lung
Term
Chondrosarcoma
Definition
>60 yo, prox phalanges and metacarpals!
common in pelvis
slow growing, firm, painful. soft tissue mass.
10%-metastasize
Term
Chondrosarcoma
Definition
bizarre shaped chondrocyte nuclei. NOT normal= malignant
Term
Chondrosarcoma
Definition
Must be removed surgically. does NOT respond to rad or chemo.
Term
Osteosarcoma
Definition
responds to chemo.
lowgrade more common, usually around knee.
Asso. with retinoblastoma (Rb) gene
Term
Osteosarcoma
Definition
rapidly enlarging, painful mass. usually around knee.

packet says in phalanges and metacarpals as well.
Term
Ewing's sarcoma
Definition
10-20 yo with pelvis lesion.
t(11:22) translocation
small blue round cells
Term
Soft tissue sarcoma
Definition
painless mass that has been there for a long time, recent growth.
Term
Soft tissue sarcoma
Definition
Risk factors: rad and herbicides
Term
Soft tissue sarcoma
Definition
treat with wide excision until margins are negative. amputation
Radiation: >5cm
Chemo: highgrade, >10cm, lung metastases
Term
synovial sarcoma
Definition
near joints, mc near carpus
t(x:18) translocation
Term
liposarcoma
Definition
painful with rapid growth
Term
dermatofibrosarcoma protuberans
Definition
horizontal spread, use very wide margins to excise.
Term
Malignant fibrous histiocytoma
Definition
MC in forearm
Term
RMS
Definition
MC soft tissue sarcoma in children
Term
Metastatic cancer
Definition
MC malignant bone tumor
Term
MM
Definition
MC malignant primary bone tumor
Term
Stewart-Treves syndrome
Definition
lymphangiosarcoma from chornic lymphedema following mastectomy
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