Bone Tumors

1. Diagnostic Complex

   1. General Info

      1. Bone TMRs = 1% of all malignancies

         1. Many times only find these b/c of pathologic frax, lump, or incidental x-ray finding.

-on x-ray, #1 cause of multiple holes in bones = METS (secondary)

1. Most common malignancy in bone is from METs of another cancer (2º)

1. Symptoms are often very vague.

2. Age (see later)

3. Radiographic findings alone can often determine if lesion is Benign, Aggressive, or Frankly Malignant.

   1. Site: some TMRs only occur at specific sites.

      1. Usually at sites of increased turnover (ex. metaphysis)

-Biggest metaphyses and largest amount of malignancies occur in:

Distal Femur > Proximal Tibia > Proximal Humerus.

1. Ex. Chondroblastoma on subchondral region of epiphysis of 17 year old.

1. Bone reaction to lesion?

   1. is the bone growing around the TMR (indicates a low-grade, slow growing TMR)

   2. is the TMR growing so fast that it has broken through the bone (high grade)

2. What kind of matrix is being formed? Bone? Cartilage?

1. Histology: Only after looking at clinical Sx’s, X-rays and forming a DDx to you do a biopsy.

Category: Orthopedics Notes