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Updated: Apr 1 2020

Malignant Bone Tumors

  • Overview
  • Ewing Sarcoma
    • Introduction
      • anaplastic small blue cell tumor
        • neuroectoderm origin
        • involves an 11;22 translocation
      • boys < 15 has highest incidence
      • most often seen in diaphysis of long bones, pelvis, scapula, and ribs
    • Evaluation
      • layered "onion-skin" deposition of bone
    • Prognosis, Prevention, and Complications
      • early metastasis
      • responsive to chemotherapy
  • Chondrosarcoma
    • Introduction
      • malignant cartilaginous tumor
      • seen in men 30-60 years
      • most commonly involves the central skeleton
      • may occur de novo or from progression of osteochondroma
    • Evaluation
      • expansile glistening mass
      • located in the medullary cavity
  • Osteosarcoma (osteogenic sarcoma)
    • Introduction
      • tumor of osteoblasts
      • most common primary malignant tumor of bone
      • commonly found in the metaphysis of long bones
        • e.g. distal femur or proximal tibia
      • risk factors
        • Paget disease of bone
          • results in onset in elderly
        • bone infarcts
        • radiation
        • familial retinoblastoma
          • Rb mutation
          • results in onset before third decade
    • Evaluation
      • histology
        • large pleomorphic cells producing increased osteoid
      • Radiograph
        • Codman's triangle or sunburst pattern
          • from elevation of periosteum from the cortical bone
    • Prognosis, Prevention, and Complications
      • poor prognosis
  • Bone Metastasis
    • Introduction
      • typically result in osteolytic lesions
      • exception is prostatic carcinoma
        • produces osteoblastic lesion
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