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 â unknown , genetic alterations
⢠Benign lesions â 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 â
medullary & parosteal
8. Medullary / central osteosarcoma
⢠Common, 10-20yrs, male common
⢠Metaphysis of long bones â lower end of
femur & upper end of tibia
9.
10. Based on pathogenesis â primary &
secondary
⢠Primary â unknown etiology, evidence
linking with genetic factors, period of
active growth, environmental infleunces
⢠Hereditary retinoblastoma
11. ⢠Secondary â preexisting bone diseases â
pagetâs disease of bone, fibrous dysplasia,
multiple osteochondromas, chronic
osteomyelitis, infarcts & #
⢠More aggressive
12. Medullary osteosarcoma â highly malignant
⢠Metaphysis -> extends centrally & expands
laterally on either side breaking through the
cortex & lifting periosteum -> surrounding soft
tissue
⢠X â ray â sunburst pattern due to osteogenesis
within the tumor
Codmannâs triangle â 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 â around bld
vessels
⢠Painful enlarging mass
28. ⢠Plain x- ray â destructive lytic tumor with
permeative margins
⢠Periosteal reaction produces layers of
reactive bone deposited in onion-skin
fashion
⢠Treatment chemotherapy & surgery