Bone tumors. Cartilage forming tumors Chondroma Benign tumors of hyaline cartilage probably develop from slowly proliferating rests of growth plate cartilage

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  • Bone tumors

  • Cartilage forming tumorsChondromaBenign tumors of hyaline cartilage probably develop from slowly proliferating rests of growth plate cartilage Age: 30-50Site: located in the metaphyseal region of tubular bones ( short tubular bones of the hands and feet)Usually solitaryBut may multiple in:Ollier disease : multiple chondromas involving one side of the bodyMaffucci syndrome: Multiple chondrmas with soft benign vascular tumors( angiomas) of soft tissue.

    Enchondromas : arise within the medulla Juxtacortical chondromas: arise on the bone surface

  • OsteochondromaOsteochondromas are also called exostosesIt is the most common benign tumor of bone

    Age: 10-30

    Site: metaphysis of long tubular bones, especially about the knee

    Male-to-female ratio of 3 : 1

    Benign cartilage-capped outgrowths attached by a bony stalk to the underlying skeleton.

  • Development over time of an osteochondromabeginning with an outgrowth from the epiphyseal cartilage

  • Solitary osteochondromas are usually first diagnosed in late adolescence and early adulthoodUsually follow a benign course.

    Multiple osteochondromas become apparent during childhood, occurring as multiple hereditary exostosis, an autosomal dominant disorder. Rare sarcomatous change.

  • ChondrosarcomaMalignant bone forming tumor.Age: most patients are age 40 or older Site: Arise in the pelvis, shoulder, and ribs Men to female ratio: 2-1. Classified according to site and histologic variants - intramedullary - juxtacortical Metastasize hematogenously to the lungs and skeleton

  • Miscellaneous Tumors

    A. Giant cell tumors (osteoclastoma )Locally malignant tumor of bone

    Age: occurs between 20 40 years of age.

    Site: arises in the ends of long bones particularly in relation to knee joint, jaw, radius and clavicle.

    X ray : large, lytic, and eccentric (soap bubble appearance)

  • Causes eccentric expansion of the affected bone and becomes covered by a thin shell of bone that yields under pressure giving (egg shell crackling). Infiltrates the surrounding tissues. The cut section shows areas of hemorrhage, necrosis and cyst formations4% metastasize to the lungsComplications: 1- Pathological fracture 2-It may change into frankly malignant tumor

  • B. Ewing sarcomaAnaplastic malignant bone tumorAge: 10-20 Site: Diaphysis of femur, tibia, ribs and pelvis are the favored sites.Male predominanceCharacterized by an 11;22 translocationIt follows an extremely aggressive course with early metastases

    Miscellaneous Tumors

  • Tumor-like lesionsFibrous bone defect30-50% of all children older than age 2Developmental defects rather than true neoplasms. Majority are smaller than 0.5 cm and arise in the metaphysis of the distal femur or proximal tibia 50% are bilateral or multiple Larger lesions (5-6 cm) develop into nonossifying fibromas.

  • Fibrous dysplasiaUnknown origin and develops at any age in the long bones. Pathology: Fibrous proliferation intermixed with poorly formed, haphazardly arranged trabeculae of woven bone (not line by osteoblasts) progressively replace normal bone.Types: a- Monostotic: Affecting one bone. b- Polystotic: Affecting more than one. The affected part is expanded by grey white fibrous tissue which replaces the medulla and produce thinning of the cortex.Complications: Deformity and pathological fractures. Rarely it transforms into fibrosarcoma.

  • 75% of bone metastasis originate from

    Cancers of prostate breast kidney lung thyroidMetastatic lesions are multifocal

    Produce a lytic and or blastic reaction

  • Bone metastasis

  • Bone metastasis

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