Gs Get Degrees

OSTEOCLASTOMA
OSTEOSARCOMA ENCHONDROMA CHONDROSARCOMA OSTEOCHONDROMA EWING’S SARCOMA
(GIANT CELL TUMOR)

Metaphysis,​ diaphysis
BONE ORIGIN Metaphysis (Youth) Metaphysis/ Diaphyseal Metaphysis Diaphysis Epiphysis

OLDER PATIENTS
Long bones (around Younger patients Younger patients
BODY Affects Axial Skeleton (pelvis, Long Bones (femur)
knee)(youth) Short tubular bones of Only in bones with Around knee and radius
LOCATION proximal humerus, proximal Flat bones of the pelvis
Flat bones (elderly) hands and feet endochondral ossification
femur)

Intramedullary (low
grade) Arised from displaced
LAYER Juxtacortical
Intracortical (high Medullary Cavity fragments of growth plates
AFFECTED Intramedullary
grade)
Juxtacortical (both)
Cartilage (hyaline +
Cartilage
NORMAL myxoid)
Bone Malignant chondrocytes with Cartilage No Normal Counterpart No Normal Counterpart
TISSUE Well-differentiated
atypia to form tumor giant cells
Normal chondrocytes

Mononuclear Cells are

MALIGNANCY Malignant Benign- if single Malignant Benign Malignant
malignant
Bimodal:
Youth
AGE Affects 20-40 Old adults Young Adults Younger patients (10-15) Affects 20-40
Elderly (paget’s,
radiation)
P53, RB (hereditary or Ollier’s
ETIOLOGY/ Follows Enchondroma
sporadic) Assoc.(unilateral) PNET
ASSOCIATION Ollier’s Assoc. EXT gene family mutation Paget​’s disease
MDM2 (sporadic) Maffuci’s t(11;22), t(21;22)
S Maffuci’s Assoc.
Retinoblastoma Assoc. Assoc.(bilateral)
 Gs Get Degrees

Codman’s Triangle
(elevation of
“O Ring” sign –
periosteum d/t dev. of Onion Skin appearance on Soap bubble Appearance
INVESTIGATIO Radiolucent mass of
new bone) Radiolucent mass (cartilage) Radiolucent mass X-Ray (lytic) on X-ray
N (Xray) cartilage w/ central
Sunburst Appearance Small round blue cells
calcification
(reactive bone
formation)
Arise in
medullary
cavity, invade
cortex

Composed of ​well Gross - ​islands of hyaline &

circumscribed myxoid cartilage(expand in the Histo​: Looks like growth
nodules of hyaline medullary cavity) plate - mushroom like
Morphology
cartilage containing growth
benign chondrocytes H&E: ​myxoid Surface of bone
Peripheral of nodule - cartilage(multiple
Gross ​- Proximal endochondral chondrocytes in one lacunae) Gross:​ hemorrhage &
femur- bulky tumor, ossification, calcify, with islands of hyaline b​road sheets and large nests of necrosis
gritty, gray white w/ infarct. cartilage uniform, small polygonal cells
hemorrhage & cystic H&E:​ multinucleated
Pleimorphic chondrocytes, with scanty pale cytoplasm &
degeneration nuclear atypia, mitotic figures Osteoclast-type giant cells
indistinct cell borders. Nuclei
H&E: ​lace-like osteoid are round to oval with finely & neoplastic mononuclear
laid down by malignant dispersed chromatin (salt and stromal cells. Tumor cells
osteoblasts pepper appearance), some are fibroblastic & histiocytic
hyperchromasia, mitotic figures
Chondrosarcoma
Giant Cells – Benign
Maffucci’s → Can fracture and cause
Hematogenous spread
COMPLICATIO Hematogenous Spread extraarticular tumors - Hematogenous Spread pain d/t pedunculated Most aggressive
(Lungs)
NS (Lungs) soft tissue angiomas, (Lungs) appearance. Can also Metaplasia
Can locally invade & recur
CNS gliomas, ovarian impinge on nerves
after removal
carcinomas
Pain, pathological fractures
Pain, pathological Pain, pathological
SYMPTOMS Breathlessness, chest pain, Mass, pain, disfigurement Painful enlarging mass Pathological fractures, pain
fractures fractures
hemoptysis