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Osteoma
- Benign
- Asymptomatic
- Loc: Membranous Bone, Paranasal/Frontal Sinus, Ethmoidal(MC)
- Lesions: Don't get >2cm, round/oval, well circumscribed radiopaque
- Features: A bone hematoma
- high correlation w/ Gardener's Syndrome, triad of abnormal growth (multiple oseteomas, colonic polyps, soft tissue fibromas)
- Misc: most require no treatment
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Osteoid Osteoma
aka Giant Osteoid Osteoblastoma
- Benign
- age & sex: 10-25 yoa 2:1 male
- Severe pain, worse at night w/ vasomotor disturbances (sweating, increased temp)
- loc: metaphysis, localized, pin-point, femur neck of trochanter, tibiam big tubular bones
- Lesions: geographic, eccentric, solid periosteal, including density around radiolucent nidus, short zone, course trabecul, 3 locations cortical, medullary, b/t periosteum and cortex
- Features: painful/rigid scoliosis (lesion on concave side): spine, dense pedicle, t.p., facet, lamina
- MiscL hard to see on plain film, need CT
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Osteoblastoma
- Benign
- Age & Sex: <20 yoa, 10-20 yoa, 2:1 male
- Very Rare
- localized pain; painful scoliosis; not relieved by asprin
- Loc: neural arch of spine, S.P. T.P. Lamina; metaphysis
- Lesions: radiolucent, very expansile thin peripheral cortical rim, >2cm
- Features: rare in spine, paraspinal pleural line
- Central ScleroticL Teens metatisize to lungs, cod triangle, distal femur; Central Lytic: moth eatten/permeative, tubular bone, Codman's triangle, path fx, no defined geo lesion
- Misc: may have recent trauma
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Parosteal
- Malignant
- Rare
- Localized Pain
- Loc: Grown out into soft tissue
- Features: Islands of tumor bone function main tumor, radiolucency between tumor and periosteum
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Periosteal
- Malignant
- Rare
- Lesions: between host cortex and periosteum (doesn't enter cortex/bone)
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Enchondroma
- Benign
- Age: 10-30 peack, 3rd decade
- Incidence: most common benign bone tumor of hand
- Asymptomatic
- Loc: Hands: long small tublar bones or feet/ribs, metaphysis or diaphysis & foot
- Lesions: thinned cortex, central, well defined margins, endosteal scalloping, radiolucent, geographic, expansice lytic, calcify
- Features: may show matric calcification on xray; ectopic cartilafe, pathological Fx
- MISC: Ollier's - multiple bone deformity; Mafucci's Synd. - enchon + soft tissue hemangiomas
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Osetochondroma
aka Bony Exostosis
- Benign
- Age: <20; 2:1 male
- Incidence: Most common benign skeletal tumor overall
- Asymptomatic
- Location: Metaphyseal; knee, femur, most common; then humerus, tibia, hip
- Lesions: An extension of the bone; three presentations: 1. solitary (most common) 2. Multiple/Few (2-3), 3. HME a bunch (20%), bayonet deformity of wrist
- Features: Pedunculated - "coat hanger exostosis; elongated STALK with narrow blended base of attachment to host away f/ joint from muscle pull; cartilage cap over bony formation of caclification Sessile - NO STALK, wide base of attachment, looks like a bump
- MISC: If becomes malignant = chondrosarcoma
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Fibromyxoidchondroma
aka Chondromyxoid Fibroma
- Benign
- Age: 10-30
- Incidence: Uncommon
- Symp: Gets more and more painful as lesion grows
- Location: proximal tibia
- lesions: geographic. expansile, soap bubble, radiolucent, eccentric, oval/round, long axis, parallel to bone; endolsteal scalloped border, cortex border thin but defined.
- MISC: Known as a "Junk" tumor f/ mixed histology
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Chondroblastoma
aka Codman's Tumor
- Benign
- Age: 10-25, 2nd decade 2:1 male
- Rare
- Symp: PAINFUL, referred to adjacent joint
- Location: Epiphysis; most common in humeral head, also long bones of lowe extremity and in big apopysis, distal/proximal femur in medullary cavity
- Lesions: Cotton wool appearance, 3-6 cm; radiolucent, geographic, eccentric, round/oval, lytic, expansile, round, thins cortex
- Features: Only true tumor to originate in the epiphysis; central calcification, metaphysis periostils
- MISC: Can lead to collapse of femur head
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Chondrosarcoma
- Malignant
- Age: 30-50 2:1 male
- Incidence: 3rd most common primary bone tumor; MC primary malignant tumor of hand
- Symp: pain late in process, swelling
- Location: metaphyseal; pelvis, proximal femur and humerous, ribs, scapular, strenum, etc.
- Lesions: Periosteal = "cleavage plant" between normal bone adn neoplasm; expansile, round/oval radiolucenies with ill defined margins, endosteal scalloping; inside bone
- Features: Develop from Enchondroma; malignant degeneration of Ollier's disease, closer lesion to axial skeleton, higher protential for malignant degeneration
- MISC: Osteochondroma becomes malignant Chondrosarcoma
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Osetosarcoma
aka Osteogenic Sarcoma
- Malignant
- Age: 10-25 2:1 males
- Incidence: 2nd most common primary bone tumor
- Symp: Pain
- Location: medullary space; long bones of extremities; both femurs and in tibula
- Lesions: Mottled, permeative, poorly defined sozen of transition. diffuse solid periosteal rxn secondary to hypertrophic osetoarthrophathy extends into soft tissue; dense ivory/sclerotic region filling medial space
- Features: F/ METS to lungs; hypertrophic osteoarthropathy; TRIAD - 1/ clubbing of digits 2. perioseal rxn 3. peripheral arthritis; may metastasize to lung fields
- MISC: ET xray P. 1021, knee xray, cannonball met in lung
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Giant Cell Tumor of Bone
aka Osteoclastoma
- Quasi-Malignant: 80% Benign/20% Malignant
- Age: 20-40
- Benign: 3:2 Females; Malignant 3:1 males
- Incidnece: most common benign of sacrum
- Symp: localize intermuscular achey pain, restricts movement
- Location: most in knee, then distal femur, promixial tibia
- Lesions: Scalloping fo inner cortex (thin & extended) and endosteal, large radiolucencies, eccentric, classic soap bubble lesion, round/oval, poorlu degined margin, wide zone of transistion
- Features: Adult = subarticular F/ epiphysis and extend up; Highly cascular lesion; neoplasm from non bone forming CT; post tramatic
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Ewing's Tumor
aka Sarcoma
- Malignant
- Age: 10-25 TEEN (15)
- race: LC in Americans
- Incidence: 4th most common primary malignant bone tumor
- Symp: Deep, localized achy bone pain; fever/lethargic, mimic osteomyelitis
- location: diaphysis of larger tubular & flat bones
- lesions: permeative, classicaly laminated can be spiculated, periosteal reaction (onion peel), bone dest rxn in diaphysis, wide zone of transistion codmans triangles.
- features: aggressive, fast growing, mixed lesions
- Misc: MC primary maliginat bones tumor in 1st decade, may see cannonball mets in lungs
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