Updated: 4/1/2020

Malignant Bone Tumors

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Topic
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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Questions (7)
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