BONE TUMORS

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BONE TUMORS
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Bone tumors

• Bone tumors are classified into
• Primary bone tumors
• Secondary bone tumors ( Metastasis)
• Most are classified according to the normal cell
  of origin and apparent pattern of differentiation
  

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Bone tumors

• Bone-forming tumors
• Cartilage-forming tumors
• Miscellaneous tumors
• Hematopoietic tumors
• Fibrous tumors

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Primary Bone Tumors

• Bone-Forming tumors
• Osteoma
• Osteoid osteoma and osteoblastoma
• Osteosarcoma
• Cartilage-Forming tumors
• Chondroma (Enchondroma)
• Osteochondroma
• Chondrosarcoma

• Miscellaneous tumors
• Ewings sarcoma
• Giant cell tumor of bone

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• Bone-Forming Tumors

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Osteoma

• Osteoma are benign lesions of bone that in many
  cases represent developmental aberrations or
  reactive growths rather than true neoplasms.
• Site
• Age
• Gross
• Histology

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Osteosarcoma

• Osteosarcoma is a bone-producing malignant
  mesenchymal tumor .

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Osteosarcoma

• Incidence
• Age
• Sex
• Site

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Osteosarcoma Distribution
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Osteosarcoma Radiograph
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Osteosarcoma Gross features
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Bone-Forming tumors
Tumor Type Locations Age Morphology
BENIGN Osteoma Facial bones, skull 40-50 Exophytic growths attached to bone surface histologically resemble normal bon
Osteoid osteoma Metaphysis of femur and tibia 10-20 Cortical tumors, characterized by pain histologically interlacing trabeculae of woven bone
Osteoblastoma Vertebral column 10-20 vertebral processes histologically similar to osteoid osteoma
MALIGNANT Primary osteosarcoma Metaphysis of distal femur, proximal tibia, and humerus 10-20 Grow outward, lifting periosteum, and inward to the medullary cavity microscopically malignant cells form osteoid.
Secondary osteosarcoma Femur, humerus, pelvis gt40 Complications of polyostotic Paget disease histologically similar to primary osteosarcoma
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Cartilage -Forming Tumors
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Osteochondroma Morphology

• Osteochondromas are mushroom shaped and range in
  size from 1 to 20 cm.
• The outer layer of the head of the osteochondroma
  is composed of benign hyaline cartilage varying
  in thickness
• Newly formed bone forms the inner portion of the
  head and stalk, with the stalk cortex merging
  with the cortex of the host bone.

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Osteochondroma (exostosis)Gross
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Osteochondroma (exostosis)Microscopic
The cap is benign hyaline cartilage, resembling
disorganized growth plate undergoing endochondral
ossification. Newly formed bone forms the inner
portion of the head and stalk
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• Chondrosarcoma

• Chondrosarcomas comprise a variety of tumors
  sharing the ability to produce neoplastic
  cartilage

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ChondrosarcomaGross features

• SITE
• pelvis,
• shoulder,
• ribs.
• rarely involve the distal extremities.

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ChondrosarcomaMicroscopic

• These tumors are composed of lobules of cartilage
  with anaplastic chondrocytes in the lacunae and
  with focal enchondral ossification and
  calcification.

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Cartilage-forming Tumors
Tumor Type Locations Age Morphology
BENIGN Osteochondroma Metaphysis of long tubular bones 10-30 Bony excrescences with a cartilaginous cap may be solitary or multiple and hereditary
Chondroma Small bones of hands and feet 30-50 Well-circumscribed single tumors resembling normal cartilage arise with medullary cavity of bone uncommonly multiple and hereditary
MALIGNANT Chondrosarcoma Bones of shoulder, pelvis, proximal femur, and ribs 40-60 Arise within medullary cavity and erode cortex microscopically well differentiated cartilage-like or anaplastic
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Giant Cell Tumor

• This is a neoplasm that contains large numbers of
  osteoclast like giant cells admixed with
  mononuclear cells.
• These tumors are slightly more common in females.

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Giant Cell TumorGross
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Giant Cell TumorMicroscopic
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METASTATIC BONE TUMORS

• Metastatic tumors are the most common malignant
  tumor of bone.
• Pathways of spread
• Origin
• The radiologic appearance of metastases

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