bone tumor

1. BONE TUMORS

2. Bone tumors
◼ Bone tumors are classified into:
❑ Primary bone tumors
❑ Secondary bone tumors ( Metastasis)
◼ Most are classified according to the normal
cell of origin and apparent pattern of
differentiation

3. Bone tumors
◼ Bone-forming tumors
◼ Cartilage-forming tumors
◼ Miscellaneous tumors
◼ Hematopoietic tumors
◼ Fibrous tumors

4. Primary Bone Tumors
Bone-Forming tumors
❑ Osteoma
❑ Osteoid osteoma and
osteoblastoma
❑ Osteosarcoma
Cartilage-Forming tumors
❑ Chondroma
(Enchondroma)
❑ Osteochondroma
❑ Chondrosarcoma
Miscellaneous tumors
− Ewing’s sarcoma
❑ Giant cell tumor of
bone

5. ◼ Bone-Forming
Tumors

6. Osteoma
◼ Osteoma are benign lesions of bone that in many cases
represent developmental aberrations or reactive growths
rather than true neoplasms.
◼ Site;
◼ Age;
◼ Gross:
◼ Histology:

8. Osteosarcoma
◼ Osteosarcoma is a bone-producing
malignant mesenchymal tumor .

9. Osteosarcoma
◼ Incidence:
◼ Age:
◼ Sex:
◼ Site :

10. Osteosarcoma
Distribution

11. Osteosarcoma
Radiograph

12. Osteosarcoma
Gross features

15. Bone-Forming tumors;
Tumor Type Locations Age Morphology
BENIGN
Osteoma Facial bones, skull 40-50 Exophytic growths
attached to bone
surface; histologically
resemble normal bon
Osteoid osteoma Metaphysis of femur
and tibia
10-20 Cortical tumors,
characterized by
pain; histologically
interlacing trabeculae
of woven bone
Osteoblastoma Vertebral column 10-20 vertebral processes;
histologically similar
to osteoid osteoma
MALIGNANT
Primary
osteosarcoma
Metaphysis of distal
femur, proximal tibia,
and humerus
10-20 Grow outward, lifting
periosteum, and
inward to the
medullary cavity;
microscopically
malignant cells form
osteoid.
Secondary
osteosarcoma
Femur, humerus,
pelvis
>40 Complications of
polyostotic Paget
disease;
histologically similar
to primary
osteosarcoma

16. Cartilage -
Forming Tumors

17. Osteochondroma
Morphology
•Osteochondromas are mushroom shaped and range in size from 1 to 20 cm.
•The outer layer of the head of the osteochondroma is composed of benign
hyaline cartilage varying in thickness
•Newly formed bone forms the inner portion of the head and stalk, with the
stalk cortex merging with the cortex of the host bone.

18. Osteochondroma (exostosis)
Gross

20. Osteochondroma (exostosis)
Microscopic
The cap is benign hyaline cartilage, resembling disorganized growth
plate undergoing endochondral ossification. Newly formed bone forms
the inner portion of the head and stalk

22. ◼Chondrosarcoma
◼Chondrosarcomas comprise a
variety of tumors sharing the ability
to produce neoplastic cartilage

23. Chondrosarcoma
Gross features
◼ SITE;
◼ pelvis,
◼ shoulder,
◼ ribs.
◼ rarely involve the distal extremities.

25. Chondrosarcoma
Microscopic
◼These tumors are composed of lobules of cartilage with anaplastic
chondrocytes in the lacunae and with focal enchondral ossification and
calcification.

27. Cartilage-forming Tumors;
Tumor Type Locations Age Morphology
BENIGN Osteochondroma Metaphysis of long
tubular bones
10-30 Bony excrescences
with a cartilaginous
cap; may be solitary
or multiple and
hereditary
Chondroma Small bones of hands and
feet
30-50 Well-circumscribed single
tumors resembling
normal cartilage; arise
with medullary cavity of
bone; uncommonly
multiple and hereditary
MALIGNANT
Chondrosarcoma Bones of shoulder,
pelvis, proximal
femur, and ribs
40-60 Arise within
medullary cavity and
erode cortex;
microscopically well
differentiated
cartilage-like or
anaplastic

28. Giant Cell Tumor
◼ This is a neoplasm that contains large numbers of
osteoclast like giant cells admixed with mononuclear
cells.
◼ These tumors are slightly more common in females.

29. Giant Cell Tumor
Gross

31. Giant Cell Tumor
Microscopic

33. METASTATIC BONE TUMORS
◼ Metastatic tumors are the most common
malignant tumor of bone.
◼ Pathways of spread:
◼ Origin:
◼ The radiologic appearance of metastases