Proximal Long Bone

Map Branches

• Bone forming Tumor (19% of cases)
  • Osteoblastoma
    • Benign
      • Round or Oval Tumor
        • Frequently in Spine
          • Dull, Achy Pain
  • Osteoid Ostema
    • Benign
      • Round or Oval Tumor
    • Onset = Teens - Twenties
      • Male 2 : 1
    • Less than 2 cm in Diameter
    • Predilection (an established preference for something)for appendicular skeleton
      • 50% involve Femur or Tibia
    • Commonly arise from Cortex
    • Has Nidus
      • Radiolucency w/Central Mineralization
    • Painful Lesion
  • Osteoma
    • Benign
      • Round or Oval tumor
        • Project from SubPeriosteal or Endosteal surface of Cortex
    • Solitary
    • Onset = Middle aged Adult
    • Slow growing
  • OsteoSarcoma
    • MALIGNANT mesenchymal Tumor
      • Most common 1o Malignant tumor of BONE
    • Onset = Adolescence
      • Dist. 75% in younger then 20 YO, Elderly
    • Frequency Male 1.6 : 1
    • Location = Metaphysis of DISTAL FEMUR or PROXIMAL TIBIA (60%)
    • Pathogenesis
      • Genetic Mutations
      • Develop @ sites of greatest bone growth
    • Morphology
      • Characterized by Anatomic portion of Bone where arise
      • Primary or Secondary
      • Degree of Differentiation
      • Bulky Tumors
      • Destroys Surrounding Cortex
      • Produces SOFT TISSUE MASS
      • Coarse lace like pattern of NEOPLASTIC bone
      • Vascular invasion possible
    • Clinical Course
      • Painful
        • Progressively enlarging Masses
      • Pathological Fracture
      • Blastic and Lytic Presentation
      • Periosteal Osteolysis
      • Codman's Triangle Present
      • 90% have lung, brain, bone metastasis
      • Chemotheraphy
      • Survival rate 60-70%
• Cartilage forming Tumors (22% of cases)
  • Osteochondroma (Aka Exostosis)
    • Benign Cartilage Capped outgrowth
    • Attached to Bony Stalk
    • Single or Multiple
    • Genetic = AUTOSOMAL DOMINANT
    • Onset = Childhood to early AdultHood
      • Male 3 : 1
    • Metaphysis of LONG TUBULAR BONES
    • Morphology
      • Mushroom Shaped
      • 1-20cm
    • Slow growing mass
    • Painful if impinging Nerve
  • Chondroblastoma
    • Rare BENIGN TUMOR = < 1%
    • Onset = Teens
    • Male 2 : 1
    • Arise near Knee
    • Predilection of Epiphysis
    • Morphology
      • Sheet w/well defined border
      • Chicken wire pattern
    • Painful
    • Located near Joint
    • Vascular invasion possible
    • Treatment = Surgical Excision or crettage
  • Chondroma (Aka Enchondroma =Involves Medulla)
    • Benign Hyaline Cartilage tumor
    • Most common Interosseous Tumor
    • Onset = 20 to 50 YO
    • Single
    • Found in Metaphyseal region of Tubular Bone
    • Sites = Hand or Foot
    • MULTIPLE ENCHONDROMA = ENCHONDROMATOSIS (Aka Ollier Disease)
    • Morphology
      • < 3 CM
      • Well Defined Oval Lucency
    • Asymptomatic
    • Detected by incidental Findings
  • Chondromyxoid Fibroma
    • Rarest and Benign
      • Sub-classified by site
    • 2nd Most common MALIGNANT matrix producing tumor of Bone
    • Onset = 40 YO
    • Male 2 : 1
    • Morphology
      • Malignant Hyaline and Myxoid Cartliage
      • Tumor Viscous and gelatinous
      • Spotty cacification
      • Leads to CENTRAL NECROSIS
    • Location
      • Trunk
      • Limb Girdle
      • Proximal Long Bone
      • Rare in DISTAL Extremities
    • Painful
    • Progressively Enlarging Mass
    • Spread Preferentially to LUNG and SKELETON
    • Treatment = Wide Surgical excision and Chemotherapy
• Matrix producing and fibrous = Most Common
  • Most common Benign = OSTEOCHONDROMA & Fibrous Cortical Defect
    • Benign more Prevalent = Onset = 1st 3 decades
  • Most common Malignant = OSTEOSARCOMA, CHONDROSARCOMA & EWING SARCOMA
    • Malignant Onset = Elderly

Comments

► Comments for document "CNS Infections"

	Kathleen Sundmark almost 4 years ago	Great info. Lots of work. Thank you for these maps. They represent a lot of information and a great deal of work.

	Edward Shekhter almost 4 years ago	Re: Great info. Lots of work. Thank you. Just got NovaMind about 3 weeks ago. This is my first go at it. There is so much information, but I am not sure if the way I presented/did this is the best way. Also I am looking for more insight and better way to do these mind maps, from experienced people.

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