2. • Bone tumors diverse in size & gross &
histologic features
• Inocuous to rapidly fatal
• Critical to diagnose , stage & treat
• Classified according to normal tissue type
they recapitulate or normal cell
3.
4. • Benign tumors within first 3 decades of life
• Elderly malignant
• Cause – unknown , genetic alterations
• Benign lesions – asymptomatic
• Pain , slow growing mass , sudden
pathologic fracture
• Radiology & biopsy
5. BONE FORMING TUMORS
• Production of bone by neoplastic cells
• Tumor bone deposit as woven trabeculae
& variably mineralized
7. • Metaphyseal region of long bones of
extremities
• Depending on their location within bone –
medullary & parosteal
8. Medullary / central osteosarcoma
• Common, 10-20yrs, male common
• Metaphysis of long bones – lower end of
femur & upper end of tibia
9.
10. Based on pathogenesis – primary &
secondary
• Primary – unknown etiology, evidence
linking with genetic factors, period of
active growth, environmental infleunces
• Hereditary retinoblastoma
11. • Secondary – preexisting bone diseases –
paget’s disease of bone, fibrous dysplasia,
multiple osteochondromas, chronic
osteomyelitis, infarcts & #
• More aggressive
12. Medullary osteosarcoma – highly malignant
• Metaphysis -> extends centrally & expands
laterally on either side breaking through the
cortex & lifting periosteum -> surrounding soft
tissue
• X – ray – sunburst pattern due to osteogenesis
within the tumor
Codmann’s triangle – formed at the angle
between elevated periosteum & underlying
surface of cortex
17. • Tumor cells have large hyperchromatic
nuclei , bizarre tumor giant cells
• Formation of bone by tumor cells- lace like
architecture , deposited in broad sheets or
primitive trabeculae
23. Parosteal / Juxtacortical osteosarcoma
• Uncommon, better prognosis
• Older age grp
• Lower end of femur, upper end of
humerus
24. MISCELLANEOUS TUMORS
Ewing sarcoma
• 10 -15 yrs, highly malignant
• Shafts & metaphysis of long bones
• Arise in medullary cavity , invades cortex
& periosteum producing soft tissue mass
• Tan with areas of hemorrhage & necrosis
25. • Sheets of uniform small , round cells with
scant cytoplasm
• Homer- Wright rosettes – around bld
vessels
• Painful enlarging mass
28. • Plain x- ray – destructive lytic tumor with
permeative margins
• Periosteal reaction produces layers of
reactive bone deposited in onion-skin
fashion
• Treatment chemotherapy & surgery