Disorder Common Locations Age Morphology/Gross/Clinical Histo/Tx/Dx

Osteoma Facial bones, skull 40-50 Rxtive growth, exophytic, resemble normal bone histo
Osteoid Osteoma Metaphysis of tibia Teens, Cortical tumor, pain due to PG release from tumor Lots of o-blasts, cells around edges of spicules, progenitor cells
20s improve with aspirin, small <2cm, nidus of woven bone bw spicules; mistaken for osteogenic sarcoma
♂ w/ sclerotic rim (bullseye) Tx-en-bloc resection
Osteoblastoma Axis, Vertebral column Like Big osteoid ostemoa, >2.5cm, more aggressive, grows and Woven bone, very cellular
(metaphysis) above causes pain Dx: X-ray, history
Osteosarcoma (1o) (Arise Mostly Metaphysis of distal Teens Malignant, metastasize (lung), bone disruption, Dx: malignant osteoid- pink, amorphous substance w/o cells in
de novo) femur, prox tibia & hum spiculization→cloud effect into soft tissue; edges of bone it, rimmed by o’blasts making the osteoid
Osteosarcoma (2o) (DZ Femur, humerus, pelvis older R irregular→fuzzy appearance; grow large w/out pain; Px: amputation, chemo
complication-Paget, bone form Codman’s triangle-tumor, periosteum, cortex meet; Prognosis: better in jaw, worse w/Paget’s dz
infarcts, prior irradiation, )
Osteochondroma Metaphysic of long tubular young Mechanical defect of epi plate→cartilage herniates thru Rare- chondrosarcoma development in cap
bones ♂ plate, migrates toward metaphysis→core of bone covered Genetic defect- multiple hereditary exostosis: multiple
by thick cap of cartilage (benign) osteochondromas in all long bones→ ↑ chondrosarcoma
Chondroma Distal to Ankles, wrist 20-40 Developmental defects; as epiphysis grows, small islands Ollier’s- rare, non-hereditary, multiple chondromas, ↑↑risk of
(metaphysis) of cartilage left behind; (benign); soap bubble appear chondrosarcoma
w/sharply defined margins, some sclerosis, lobulated, Marfucci’s→ rare, non-hereditary, multiple chondromas w/
bluish cartilage in the metaphysis hemangioma, ↑ risk for chondrosarcomas
Tx: en bloc resection (won’t recur)
Chondroblastoma Epiphyeal tumor 10-20 Dense sclerotic margin b/c slow growing, center will be Grooves in nuclei of chondroblastoma, multi-nucleated giant
radiolucent cells, high cellularity
Chondromyxoid Fibroma Metaphysis 10-20 Differ from above by location Like above
Chondrosarcoma Bones of shoulder, pelvis, 50 5 types- 1o , 2o , de-differentiated, mesenchymal (young), Clustering of cartilage, nuclear pleomorphism, binucleation;
prox femur, ribs ♂ clear cell (young) Grade 1: 100% for 5 yrs, Grade 2: 70% for 5 yrs, Grade 3: 40-
50% for 5 years

Non-ossifying Fibroma Metaphyseal fibrous defect Young Fibrous tissue in bone w/ sclerotic margins , sharply ↑cellularity, fibrous tissue, multi-nucleated giant cells
defined w/lucent center; fractures can occur along fibrous
tissue lines; Red-brown (unique); benign
Fibrous Dysplasia Metaphysis; Young Benign (but can be locally aggressive) Chinese characters formed by bony spicules
Monostatic-ribs adults Albrights Syndrome- polyostotic Fibrous Dysplasia,
Polystatic- ribs, spine, skull, cutaneous pigment, endocrine abnormalities
pelvis
Fibrosarcoma Metaphysis going down to Older Infrequent lesion; Ratty appearance HERRINGBONE pattern
diaphysis Grow fairly quickly, cause fractures, erode into soft tissue Prominent cells: spindle-shaped fibroblasts;
Malignant
Bone Tumors
Giant Cell Tumor Epiphyseal 20-40 No cartilage or fibrous tissue **Giant cells R uniformly spaced; nuclei in giant cells are
♀ Benign but very aggressive→ malig lesion (50%) identical to stroma cells
Ewing’s Diaphysis kids Painful; medullary cavity origin; translocation 11,22 Small round blue cell tumor; neuroendocrine tumor

Benign cartilage-uniform distribution of chondrocytes, single chondrocyte per lacuna, no mitotic figures, no necrosis
Malignant cartilage-more cellular, binucleation, mitotic figures, necrosis