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Pathology of Bone Tumors
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Osteosarcoma
Characteristics: Malignant, osteoid-producing tumor. Typical location: Long bones (distal femur, proximal tibia). Potential treatments: Surgery, chemotherapy, and possible limb-sparing procedures.
Metastatic Bone Disease
Characteristics: Secondary bone tumors from other primary cancers. Typical location: Spine, pelvis, ribs, and long bones. Potential treatments: Depends on primary cancer; may include chemotherapy, radiation therapy, and surgery.
Simple Bone Cyst
Characteristics: Benign fluid-filled cavity. Typical location: Proximal humerus and femur. Potential treatments: Observation, aspiration, and injection with steroids or bone marrow, surgical curettage with bone grafting.
Aneurysmal Bone Cyst
Characteristics: Expansive and blood-filled bone lesion. Typical location: Metaphysis of long bones and vertebrae. Potential treatments: Curettage with bone grafting, embolization, and possible excision for recurrent cases.
Osteoblastoma
Characteristics: Benign bone lesion larger than osteoid osteoma. Typical location: Spine and long bones. Potential treatments: Surgical excision, curettage with bone grafting.
Osteochondroma
Characteristics: Benign bone tumor with a cartilage cap. Typical location: Metaphysis of long bones, such as the femur and tibia. Potential treatments: Observation, surgical excision if symptomatic or for suspected malignancy transformation.
Enchondroma
Characteristics: Benign cartilage tumor within the medullary bone. Typical location: Small bones of the hands and feet, long bone diaphysis. Potential treatments: Observation, surgical curettage and bone grafting if symptomatic or for suspected malignancy.
Chondrosarcoma
Characteristics: Malignant cartilage-forming tumor. Typical location: Pelvis, femur, and shoulder. Potential treatments: Surgical resection, sometimes with adjuvant chemotherapy or radiation.
Multiple Myeloma
Characteristics: Malignant plasma cell disorder affecting bone marrow. Typical location: Vertebral bodies, ribs, skull, pelvis, and femur. Potential treatments: Chemotherapy, stem cell transplant, radiation therapy, and supportive care.
Fibrous Dysplasia
Characteristics: Benign, fibrous bone lesion replacing normal marrow. Typical location: Femur, tibia, ribs, and skull. Potential treatments: Observation, surgical curettage and bone grafting, bisphosphonates to decrease pain.
Adamantinoma
Characteristics: Low-grade malignant tumor, epithelial origin. Typical location: Tibia primarily, sometimes the fibula. Potential treatments: Wide surgical resection, occasionally amputation for extensive disease.
Ewing Sarcoma
Characteristics: Highly malignant tumor with small round cells. Typical location: Pelvic bones, femur, and chest wall. Potential treatments: Multiagent chemotherapy, surgery, and radiation therapy.
Osteoid Osteoma
Characteristics: Benign, small, and painful tumor. Typical location: Cortex of long bones, particularly the femur and tibia. Potential treatments: Nonsteroidal anti-inflammatory drugs (NSAIDs), radiofrequency ablation, or surgical excision.
Giant Cell Tumor of Bone
Characteristics: Generally benign but can be locally aggressive. Typical location: Epiphyses of long bones, especially around the knee. Potential treatments: Curettage with bone grafting or cement, wide resection in recurrent cases.
Chordoma
Characteristics: Malignant tumor of notochordal origin. Typical location: Sacrum and base of the skull (clivus). Potential treatments: Wide surgical resection, postoperative radiotherapy, new targeted therapies under investigation.
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