| Second most common primary bone tumor | OSTEOSARCOMA |
| OSTEOSARCOMA (site of origin): arise within medullary cavity | Conventional |
| OSTEOSARCOMA (site of origin):arise from periosteal surface | Juxtacortical |
| OSTEOSARCOMA (site of origin):arise in soft tissue | Extraskeletal |
| membrane that covers the outer surfaces of bone, outermost surface of bone | periosteal surface |
| hollow part of the bone that contains the bone marrow | medullary cavity |
| mandibular paresthesia can occur in osteosarcoma if ________ is involved | inferior alveolar nerve |
| OSTEOSARCOMA: clinical features: | swelling, localized pain, loosening & displacement of teeth |
| maxillary paresthesia can occur in osteosarcoma if ________ is involved | infraorbital nerve, epistaxis, nasal obstruction, or eye problem |
| OSTEOSARCOMA(RADIOGRAPHIC): the more ___________- the more presence of radiopaque discoloration | calcification |
| OSTEOSARCOMA(HISTOPATHOLOGIC): Sarcomatous stroma directly producing _________ | tumor osteoid |
| OSTEOSARCOMA(HISTOPATHOLOGIC patterns): malignant bone and ostoid bone predominate | Osteoblastic |
| OSTEOSARCOMA(HISTOPATHOLOGIC patterns): most common; the jaws | Chondroblastic |
| OSTEOSARCOMA(HISTOPATHOLOGIC patterns): spindle cells predominate | Fibroblastic |
| OSTEOSARCOMA(HISTOPATHOLOGIC patterns): multiple aneurysmal blood-filled spaces lined by malignant cells | Telangiectatic |
| OSTEOSARCOMA(HISTOPATHOLOGIC): More ___________ in jaw than those in the skeleton, better prognosis | differentiated |
| OSTEOSARCOMA(DX): widening of periodontal ligament space | Scleroderma |
| OSTEOSARCOMA(DX): moth eaten radiographic appearance | Chronic osteomyelitis, other malignancies, several benign neoplasms |
| OSTEOSARCOMA(DX): sclerotic radiographic appearance | Pindborg tumor and metastatic carcinomas |
| OSTEOSARCOMA(DX): histologic appearance | Chondrosarcoma, fibrosarcoma of bone, aneurysmal bone cyst or giant cell tumor |
| (removal of the portion of mandible or maxillary) | Radical mandibulectomy or maxillectomy |
| OSTEOSARCOMA(TX): for recurrences, soft tissue extension metastatic disease | Radiotherapy and chemotherapy |
| OSTEOSARCOMA(TX): mandibular osteosarcoma | Presurgical insertion of radium needles |
| OSTEOSARCOMA(TX): survival rate of ___ in 5 years for tx using Presurgical insertion of radium needles | 76% |
| OSTEOSARCOMA (PROGNOSIS):Overall, 5 year survival rate for ___________of jaw osteosarcoma | 35 to 40% |
| OSTEOSARCOMA (PROGNOSIS): what arch has a better prognosis | mandibular |
| OSTEOSARCOMA (PROGNOSIS):Rarely metastasize to | lymph nodes |
| OSTEOSARCOMA (PROGNOSIS):Most common sites of metastasis – ______; ______ survival rate | lung and brain; 6 months |
| OSTEOSARCOMA (PROGNOSIS):Local recurrences – | surgical excision and chemotherapy |
| JUXTACORTICAL OSTEOSARCOMA: Usually of _____ type | parosteal |
| JUXTACORTICAL OSTEOSARCOMA: Most common type osteosarcoma | PAROSTEAL |
| JUXTACORTICAL OSTEOSARCOMA: Not covered by the lining epithelial tissue | PAROSTEAL |
| JUXTACORTICAL OSTEOSARCOMA: Rare; Distinct cx,hx, biologic and rx features | PERIOSTEAL |
| JUXTACORTICAL OSTEOSARCOMA: Arise the periphery of bone at the _____ surface | PERIOSTEAL |
| PAROSTEAL OSTEOSARCOMA is common in | long bones |
| PAROSTEAL OSTEOSARCOMA: gender | female |
| PAROSTEAL OSTEOSARCOMA:Most commonly involves | distal femoral metaphysic |
| PAROSTEAL OSTEOSARCOMA:CLINICAL FEATURES | Slow-growing swelling or palpable mass, dull aching sensation |
| JUXTACORTICAL OSTEOSARCOMA: Periphery is ossified than the base, may have lobulated cartilaginous cap or may be irregular because extensions into soft tissue | PAROSTEAL OSTEOSARCOMA |
| PAROSTEAL OSTEOSARCOMA(radiographic):Radiodense and attached to the external surface of the bone by broad ___________ | sessile base |
| PAROSTEAL OSTEOSARCOMA: salient feature | Well-differentiated has spindle shape stroma with minimal atypia and rare mitotic figures |
| JUXRACORTICAL OSTEOSARCOMA: Well-differentiated has spindle shape stroma with minimal atypia and rare mitotic figures separating irregular trabeculae of woven bone having foci of osteoid and cartilage | PAROSTEAL OSTEOSARCOMA |
| PAROSTEAL OSTEOSARCOMA (TX) | En bloc resection |
| PAROSTEAL OSTEOSARCOMA: PROGNOSIS | Significant local recurrence underlying cortical bone |
| PERIOSTEAL OSTEOSARCOMA: Common location | upper tibial metaphysis |
| PERIOSTEAL OSTEOSARCOMA: CLINICAL FEATURES | rarely in jaw, occurs less |
| JUXTACORTICAL OSTEOSARCOMA(radiographic): Cortex of involved bone radiographically intact and sometimes thickened, with no tumor involvement of the underlying marrow cavity | PERIOSTEAL OSTEOSARCOMA |
| JUXTACORTICAL OSTEOSARCOMA(histo): Lobules of poorly differentiated malignant cartilage with central ossification, minimal tumor infiltration into cortical bone without medullary involvement | PERIOSTEAL OSTEOSARCOMA |
| PERIOSTEAL OSTEOSARCOMA (DX) | Chondroblastic intramedullary osteosarcoma |
| CHONDROSARCOMA(CLINICAL):Maxillofacial area (60%) – | lateral incisor and canine region and palate |
| CHONDROSARCOMA: SYMPTOMS | Pain, visual disturbances, nasal signs and headaches |
| CHONDROSARCOMA(CLINICAL):Mandibular area (40%) – | premolar, molar, symphysis, coronoid and condylar process |
| CHONDROSARCOMA: occur more on | anterior area |
| CHONDROSARCOMA: age | Adulthood and old age |
| CHONDROSARCOMA(Radiographic): | Moth – eaten radiolucency; diffuse opaque; uni/multi, mottle densities |
| CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):well differentiated; lobular architecture | Grade I |
| CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):intermediate; myxoid stroma w/ enlarged chondrocyte nuclei | Grade II |
| CHONDROSARCOMA(HISTOPATHOLOGIC FEATURES GRADING):poorly differentiated; celular; spindle cell component | Grade III |
| CHONDROSARCOMA: TX | Wide local radical surgical excision |
| CHONDROSARCOMA: METASTASIS | lungs or bone |
| CHONDROSARCOMA:local recurrence and extension into adjacent vital structures result in | death |
| Highly lethal round cell sarcoma | EWING’S SARCOMA |
| EWING’S SARCOMA:common location | Bones of lower extremity of pelvis |
| EWING’S SARCOMA: common loc in jaw | Ramus of mandible |
| EWING’S SARCOMA: symptoms | Pain and swelling, mucosal ulcers, Facial deformity, destruction of alveolar bone with loosening of teeth |
| EWING’S SARCOMA(HISTOPATHOLOGIC):Proliferation of _________- cells that may be compartmentalized by fibrous bands | uniform, closely packed |
| EWING’S SARCOMA(HISTOPATHOLOGIC):Round to oval nuclei have ________- inconspicuous nucleoli | finely dispersed chromatin |
| EWING’S SARCOMA(HISTOPATHOLOGIC):Cytoplasm has | glycogen |
| EWING’S SARCOMA(HISTOPATHOLOGIC):stains with | Schiff stain |
| EWING’S SARCOMA: problem with chromosomes translocation | 11 and 12 |
| EWING’S SARCOMA: radiographic | Moth eaten destructive radiolucency medullar and erosion of cortex with expansion |
| EWING’S SARCOMA: tx local | surgery and radiation |
| EWING’S SARCOMA:tx systemic | chemotherapy |
| EWING’S SARCOMA:prognosis for patient below 30 years old | poor |
| EWING’S SARCOMA:Metastatic to | lungs, other bones and lymph nodes |
| EWING’S SARCOMA: high rate of | erythrocyte sedimentation |
| EWING’S SARCOMA: elevated value of | serum lactate dehydrogenase & thrombocytosis |
| Burkitt's Lymphoma: Chromosome problem | 8-14 |
| BURKITT’S LYMPHOMA(CLINICAL):High-grade non-hodgin’s lymphoma ______ in Africa | endemic |
| BURKITT’S LYMPHOMA(CLINICAL):High-grade non-hodgin’s lymphoma _____ in North America | sporadical |
| BURKITT’S LYMPHOMA: HISTOPATH | Neoplastic B cell proliferation |
| BURKITT’S LYMPHOMA: radiograph | Moth-eaten radiolucency |
| BURKITT’S LYMPHOMA: TX | Combination chemotherapy |
| BURKITT’S LYMPHOMA: PROGNOSIS | Potentially curable |
| low red blood cell count | Anemia |
| low white blood cell count | Leukopenia |
| low platelet count | Thrombocytopenia |
| high calcium level in the blood | Hypercalcemia |
| MULTIPLE MYELOMA: gender | male |
| MULTIPLE MYELOMA: age | after 5th decade |
| MULTIPLE MYELOMA: may develop | systemic amyloidosis |
| Asymptomatic or may have pain, swelling, expansion, numbness, mobility of the teeth, or pathologic features; soft tissue mass | MULTIPLE MYELOMA |
| Weakness, weight loss, anemia and hyper viscosity | MULTIPLE MYELOMA |
| MULTIPLE MYELOMA: radiographic | punched out, expansile, osteosclerotic |
| MULTIPLE MYELOMA: histo | Monotonous proliferation of pure plasma cells |
| MULTIPLE MYELOMA:TX | Chemotherapy with local radiation |
| MULTIPLE MYELOMA:Poor prognosis for patients with | severe azotemia, hypercalcemia, anemia |
| SOLITARY PLASMACYTOMA OF BONE: age | adulthood |
| SOLITARY PLASMACYTOMA OF BONE: gender predominance | male |
| SOLITARY PLASMACYTOMA OF BONE:rare in | jaw |
| SOLITARY PLASMACYTOMA OF BONE: occur more in | angle of mandible |
| SOLITARY PLASMACYTOMA OF BONE:Diagnosis | radiologic bone survey and random bone marrow aspirate and biopsy |
| SOLITARY PLASMACYTOMA OF BONE: symptoms | Pain, swelling, pathologic fracture |
| SOLITARY PLASMACYTOMA OF BONE: histopath | monotonous proliferation of neoplastic plasma cells |
| SOLITARY PLASMACYTOMA OF BONE: radiographic | Well defined lytic lesions |
| May be multilocular, resembling central giant cell granuloma; May destroy cortical bone and spread into adjacent soft tissue | SOLITARY PLASMACYTOMA OF BONE |
| SOLITARY PLASMACYTOMA OF BONE: tx | radiotherapy |
| SOLITARY PLASMACYTOMA OF BONE:Local recurrence in ___of cases | 10% |
| SOLITARY PLASMACYTOMA OF BONE:May progress to | multiple myeloma |
| Most common malignancy affecting skeletal bones | METASTATIC CARCINOMA |
| From primary carcinomas of the breast, kidney, lung, colon, prostate, thyroid gland | METASTATIC CARCINOMA |
| METASTATIC CARCINOMA: age | 50-70 (ave-45) |
| METASTATIC CARCINOMA: location | angle and body of mandible |
| Bone pain, loosening of teeth, lip paresthesia, bone swelling, gingival mass, and pathologic fracture | METASTATIC CARCINOMA |
| METASTATIC CARCINOMA: radiographic | Poorly marginated, radiolucent, irregular, moth-even, expansile defects |
| METASTATIC CARCINOMA: tx | Surgical excision, chemoradiotherapy |
| METASTATIC CARCINOMA: 5-year-survival | 10% |
| METASTATIC CARCINOMA: dead w/in a year | two-thirds |
