xPG-Bone Tumors

Hale Waihona Puke Osteochondroma
Osteochondroma:
Osteochondroma:
Osteochondroma
Osteochondroma microscopy:
CHONDROMA (ENCHONDROMA)
Benign, Any age Single or multiple sites Often involves small bones of hands and feet. Well demarcated（分界）, mature cartilage.

OSTEOBLASTOMA
Clinically similar to osteoid osteoma (large) Also known as giant osteoid osteoma. Common location -- vertebral column Histology similar – but rare nidus. Can be locally aggressive Therapy – curettage（刮除术）/resection with bone graft.

Miscellaneous tumors
– Ewing’s sarcoma* – Giant cell tumor of bone
Tumour-like conditions of bone

Bone cysts
– Simple bone cyst – Aneurysmal bone cyst


Osteosarcoma – gross
Osteosarcoma – gross
Osteosarcoma – X-ray
Osteosarcoma Microscopy:
Malignant cells Osteoid matrix
OSTEOCHONDROMATOSIS
Hereditary (multiple) or sporadic (single， 零星的) mushroom-shaped bony projections Lateral aspects of cartilage joints. Chondrosarcoma – in hereditary type.

OSTEOSARCOMA
Common primary cancer of bone Young adults - 10 and 25 years Rare in later age – Secondary to previous irradiation or Paget’s disease genetic (retinoblastoma gene) Metaphysis of a long bone (Knee) Tenderness / pain / Mass.
Usually no obvious cause Ionising radiation Predisposing conditions: – Paget’s disease – fibrous dysplasia – retinoblastoma (genetic) – syndromes eg. Gardners, Ollier’s disease

CHRONDROSARCOMA

Malignant cartilage with anaplastic （间变） chondrocytes in spaces with focal enchondral ossification and calcification
Resistant to chemo Surgical resection Grade I tumors have 5-year survival rates of 90%, while high grade tumors have poor prognosis. Clear cell chondrosarcoma is a histologic variant that is associated with a better prognosis.
Fibrous-osseous lesions
– Fibrous dysplasia
Eosinophilic granuloma (Langerhans histiocytosis) Osteochondroma - ?hamartoma

OSTEOMA




Benign, Often craniofacial（颅面） in location Hamartomatous（错构瘤性 ） / reactive not true tumor. Histologically are woven and lamellar bone (closely resemble normal bone). Gardner Syndrome: multiple, Osteoma, osteochondroma, GIT polyps, skin tumors. Autosomal （常染色体） Dominant, Colon Cancer.
"When you paint success pictures in your mind, you initiate an inner process whereby your attitudes, hopes, aspirations, and enthusiasm are elevated in response to an image of a more promising future. Every person who aspires must first sell themselves hope, the promise of a better life."

CHONDROMA (ENCHONDROMA)
Hereditary – multiple enchondromatosis. Usually over one side of the body. (Ollier’s disease). Maffucci‘s syndrome - multiple bone chondromas and hemangiomas（血管 瘤） of soft tissue Increased risk for chondrosarcoma


>40 years of age affects axial skeleton not sensitive to chemotherapy
EWING’S SARCOMA:




Rare, young, 10-20 years, Males 2:1 Diaphysis of long bones, pelvis Histopath : sheets uniform round cells cytoplasmic glycogen（糖原质）, extensive necrosis; 11/22 translocation （骨置换） Prognosis: very poor, <10% 5-year survival with surgery and radiotherapy, 40% with adjuvant（辅助） chemotherapy
OSTEOID OSTEOMA
Benign, second decade; males (3:1) 1-2 cm lesion in cortex of femur or tibia Painful (high prostaglandin（前列腺素） levels in lesion) Central nidus（巢） of vascular spaces surrounded by interlacing reactive trabecular bone. Therapy - Resection of nidus - bone graft.
U.S. Andersen Author and Speaker
Pathology of Bone Tumors
Dr. Venkatesh M. Shashidhar
Associate Professor of Pathology Fiji School of Medicine
Etiology


Ollier’s Disease: Multiple enchondroma.
CHONDROSARCOMA
Next common to Osteosarcoma. Older adults 30 to 60 years. Location - axial skeleton (pelvis & pectoral girdles（肩带）, ribs & spine) Aggressive, erodes & invades soft tissue, Metastases to lungs, liver, kidney & brain.

Chondrosarcoma - gross
Chondrosarcoma - gross
Chondrosarcoma of Pelvis
nodules of white to bluish-white cartilagenous tumor tissue eroding and extending outward from the bone at the lower right.
Chondrosarcoma
Cartilage in chondrosarcoma:
Cartilage in chondrosarcoma:
OSTEOSARCOMA

CHRONDROSARCOMA