OsteomaPeak: middle age• Facial + cranial bones-paranasal sinuses• Long bones (Cortex)• Solitary, slowBone Formingtumor from osteoblasts(diameter < 1 cm)• Round/ oval tumor, occurs as exophytic masses on membranous bone• Usually asymptomatic, can obstruct→breathing, vision, hearing• Nasal sinus osteoma→obstruction, congestion, pressure headaches.• Associated wGardner syndrome- FamilialAdenomatous Polyposis variant- APC gene mutation→Colonic polyp disorder + skull ormandible osteoma• Compact, ivory made of maturelamellar bone• No haversian canals• No fibrous componentOsteoid osteomaPeak: teens–25 yoSex: M > F• Appendicular (not axial)•MetaphysisandDiaphysisoflong bones (Cortex)-Prox femur,tibia, humerus• Vertebrae•Bone Formingtumor - small, predominantly (reactive) cortical(< 2 cm)• Chronicnocturnal bone pain, (wks-yrs),continuous ach, limp,↓ROM•nidus with surrounding sclerosis• Pain responds to NSAIDs•X-ray:radiodense cortical (reactive) bone +radiolucent core (osteoid)• Surgery if pain unresponsive to medication.• Osteoid core- Non-mineralized bone matrix- Mostly proteins• Interconnecting trabeculae ofwoven bone• prominent osteoblast rim• Proliferating osteoblasts produceexcess PGE2 = painOsteoblastomaPeak incidence: 10–20yearsSex: M > FVertebrae (predominantlyposterior column)• Large mass in axial skeleton of osteoblast proliferation• Predominantly (reactive) cortical tumor( >2 cm)• Severe chronic pain(not nocturnal) that is unresponsive to NSAIDs• X-ray: central lucent nidus with mild or absentperifocal sclerosisOsteochondroma(Exostosis)• #1benign bonetumor• Males < 25 yo (10-30)• late adolescence/early adulthoodMetaphysisof long tubular bones:knee, humerus• only endochondral bones• Near growth plate• SlowCartilage Formingtumor, Bony stalk with cartilaginous cap• Lateral bony projection of growth plate (continuous w/ marrow space)• Stop growing with GP closure•Cartilage cap→malignant, can transform to chondrosarcoma (rarely)• Mostly asymptomatic, can cause pain (esp if stalk fractures)• Solitary (85%)or multiple (15%→Mult. HereditaryExostosis, AD)• Hereditary (EXT mut): bones bowed/ short-Disturbed epiphyseal growthTx: simple excision• Cartilage cap looks likedisorganized growth plateChondroma• 30-50 yoEnchondroma: Metaphysisofsmall bones, hands & feet• CircumscribedCartilage Formingtumor resembles norm hyaline cartilage• Not infiltrative, osteolytic, w/ calcifications•Enchondroma:arise w/inmedullary cavity•Juxtacortical chondroma:On bone surface• MUST EXCLUDE CHONDROSARCOMA•X-Ray: Predominantly lucent with internalmineralization,Narrow reactive bone rim• Nodules of hyaline cartilage• Narrow reactive bone rim• Mitotic figures only w/ fractures• Atypical mitotic figures - neverGiant-cell tumor(osteoclastoma)Peak: 20–40 yearsEpiphysisof long bones• femur, tibia (around knee)• Tumor of multinucleated giant osteoclasts→bone resorption• Expanded osteoclasts(osteoclastoma) BUT Neoplastic cells = OSTEOBLASTS-Stromal tumor cells express↑RANK-L- Stimulates non-neoplastic osteoclast proliferation/ differentiation• Usually benign but locally aggressive destructive resorption of bone matrix• Local pain and swelling, Pathological fractures, arthritismay recur after curettage.
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Term
Spring
Professor
JinksR
Tags
ulcers
