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SpOT
Orthopaedics surgeon
Christian University of Indonesia
Etiology
Usually no obvious cause
Ionising radiation
Predisposing conditions:
Pagets disease
fibrous dysplasia
retinoblastoma (genetic)
syndromes eg. Olliers disease
lung, prostate)
Marrow neoplasms (hemopoietic) myeloma,
leukemia, lymphoma etc.
Bone-producing tumors
Osteoma, osteoid osteoma, osteoblastoma
Osteosarcoma*
Cartilage-producing tumors
Osteochondroma, chondroma (enchondroma)
chondromyxoid fibroma
chondroblastoma
Chondrosarcoma*
Miscellaneous tumors
Ewings sarcoma*
Giant cell tumor of bone
PRIMARY TUMORS OF
BONE
Tumour-like conditions of
bone
Bone cysts
Simple bone cyst
Aneurysmal bone cyst
Fibrous-osseous lesions
Fibrous dysplasia
Eosinophilic granuloma (Langerhans
histiocytosis)
Osteochondroma - ?hamartoma
OSTEOMA
Benign, Often craniofacial in location
Hamartomatous / reactive not true tumor.
Histologically are woven and lamellar bone (closely
OSTEOID OSTEOMA
Benign, second decade; males (3:1)
1-2 cm lesion in cortex of femur or tibia
Painful (high prostaglandin levels in lesion)
Central nidus of vascular spaces surrounded by
OSTEOBLASTOMA
Clinically similar to osteoid osteoma (large)
Also known as giant osteoid osteoma.
Common location -- vertebral column
Histology similar but rare nidus.
Can be locally aggressive
Therapy - curettage/resection with bone graft.
OSTEOSARCOMA
Common primary cancer of bone
Young adults - 10 and 25 years
Rare in later age Secondary to previous irradiation
or Pagets disease
genetic (retinoblastoma gene)
Metaphysis of a long bone (Knee)
Tenderness / pain / Mass.
OSTEOSARCOMA
Osteosarcoma gross
Osteosarcoma gross
Osteosarcoma X-ray
Osteosarcoma Microscopy:
Malignant
cells
Osteoid
matrix
OSTEOCHONDROMATOSIS
Hereditary (multiple) or sporadic (single)
mushroom-shaped bony projections
Lateral aspects of cartilage joints.
Chondrosarcoma in hereditary type.
Osteochondroma:
Osteochondroma
Osteochondroma microscopy:
CHONDROMA (ENCHONDROMA)
Benign, Any age
Single or multiple sites
Often involves small bones of hands and feet.
Well demarcated, mature cartilage.
CHONDROMA (ENCHONDROMA)
Hereditary multiple enchondromatosis. Usually
CHONDROSARCOMA
Next common to Osteosarcoma.
Older adults 30 to 60 years.
Location - axial skeleton (pelvis & pectoral girdles,
CHRONDROSARCOMA
Malignant cartilage with anaplastic chondrocytes in
resection
Grade I tumors have 5-year survival
rates of 90%, while high grade tumors
have poor prognosis.
Clear cell chondrosarcoma is a
histologic variant that is associated with
a better prognosis.
Chondrosarcoma - gross
Chondrosarcoma of Pelvis
Cartilage in chondrosarcoma:
OSTEOSARCOMA
CHRONDROSARCOMA
>40 years of age
chemotherapy
affects axial
skeleton
not sensitive to
chemotherapy
EWINGS SARCOMA:
Rare, young, 10-20 years, Males 2:1
Diaphysis of long bones, pelvis
Histopath : sheets uniform round cells
Ewings Sarcoma:
FIBROUS DYSPLASIA
Etiology is unknown.
Dysplastic proliferation of fibrous tissue & bone
Metastatic tumors: