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Bone tumors
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Cartilage forming tumors• Chondroma
• Benign tumors of hyaline cartilage probably develop from slowly proliferating rests of growth plate cartilage
• Age: 30-50• Site: located in the metaphyseal region of tubular
bones ( short tubular bones of the hands and feet)• Usually solitary• But may multiple in:• Ollier disease : multiple chondromas involving one
side of the body• Maffucci syndrome: Multiple chondrmas with soft benign
vascular tumors( angiomas) of soft tissue.
• Enchondromas : arise within the medulla • Juxtacortical chondromas: arise on the bone
surface
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Osteochondroma• Osteochondromas are also called exostoses• It 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.
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Development over time of an osteochondromabeginning with an outgrowth from the epiphyseal cartilage
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• Solitary osteochondromas are usually first diagnosed in late adolescence and early adulthood
• Usually follow a benign course.
• Multiple osteochondromas become apparent during childhood, occurring as multiple hereditary exostosis, an autosomal dominant disorder.
• Rare sarcomatous change.
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Chondrosarcoma• Malignant 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
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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)
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• 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 formations
• 4% metastasize to the lungs• Complications: 1- Pathological fracture 2-It may change into frankly malignant
tumor
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• B. Ewing sarcoma
• Anaplastic malignant bone tumor
• Age: 10-20
• Site: Diaphysis of femur, tibia, ribs and pelvis are the favored sites.
• Male predominance
• Characterized by an 11;22 translocation
• It follows an extremely aggressive course with early metastases
Miscellaneous Tumors
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Tumor-like lesions• Fibrous bone defect
• 30-50% of all children older than age 2• Developmental 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.
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Fibrous dysplasia• Unknown 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.
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75% of bone metastasis originate from
Cancers of prostate breast kidney lung
thyroidMetastatic lesions are multifocal
Produce a lytic and or blastic reaction
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Bone metastasis
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Bone metastasis
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