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Musculoskeletal - Bone Tumors

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What is Osteochondroma?
1) Most common benign bone tumor, usu. men < 25
2) Growth covered by cartilage cap
3) Originate from long bone metaphysis like around knee
4) RARELY transform to chondrosarcoma
What is Giant Cell Tumor?
1) M=F ages 20-40 yrs
2) Common benign
3) Spindle cells mixed with giant cells
4) > 50% in knee area
5) "Soap bubble" on x-ray
What is Osteosarcoma?
Most common primary bone malignant bone tumor, affecting young men 10-20 yrs usually around knee
What are the si/sx of Osteosarcoma?
1) Pain, fracture, swelling
2) High ALP
3) Codman's Triangle: elevated periosteum by expanding tumor
What predisposes someone to Osteosarcoma?
1) Radiation
2) Retinoblastoma (del 13q)
3) Bone infarct
What is Chondrosarcoma?
Malignant cartilage tumor, in men 30-60 yrs
What is Ewing's Sarcoma?
Small anaplastic blue cell tumor resembling malignant lymphoma, see "ONION SKINNING" on x-ray
Who gets Ewing's Sarcoma?
1) Young boys < 15 yrs
2) 11:22 translocation
What is Multiple Myeloma?
Malignant clonal neoplasm of Plasma Cells producing:
- whole Abs (IgM, IgG, etc.)
- light chain Abs
- or no Abs (just inc. B-cells)
Who gets Multiple Myeloma?
Patients > 40 yrs, black twice as likely as white
How does Multiple Myeloma present?
1) Bone pain, worse with movement, back and ribs
2) Punched-out lytic bone lesions
3) Hypercalcemia
How do you Dx Multiple Myeloma?
1) SPEP: M-spike if clones making whole Abs
2) UPEP: spike if clones make light chains only
3) Osteolytic bone lesions
4) Bence-Jones proteinuria
What are Bence-Jones proteins?
Ab light chains in urine

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