BONE TUMORS

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

Bone tumors

Bone-forming tumors
Cartilage-forming tumors
Miscellaneous tumors
Hematopoietic tumors
Fibrous tumors

Primary Bone Tumors

Bone-Forming tumors

Osteoma

Osteoid osteoma and

osteoblastoma

Osteosarcoma
Cartilage-Forming tumors

Chondroma
(Enchondroma)

Osteochondroma

Chondrosarcoma

Miscellaneous tumors

Ewings sarcoma

Giant cell tumor of

bone

 Bone-Forming

Tumors

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:

Osteosarcoma

Osteosarcoma is a bone-producing
malignant mesenchymal tumor .

Osteosarcoma

Incidence:
Age:
Sex:

Site :

Osteosarcoma
Distribution

Osteosarcoma
Radiograph

Osteosarcoma
Gross features

Bone-Forming tumors;
BENIGN

MALIGNANT

Tumor Type

Locations

Age

Morphology

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

Primary

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.

Femur, humerus,
pelvis

>40

Complications of
polyostotic Paget
disease;
histologically similar
to primary
osteosarcoma

osteosarcoma

Secondary
osteosarcoma

Cartilage -Forming
Tumors

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.

Osteochondroma (exostosis)
Gross

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

 Chondrosarcoma

Chondrosarcomas

comprise a
variety of tumors sharing the ability
to produce neoplastic cartilage

Chondrosarcoma
Gross features

SITE;
pelvis,
shoulder,
ribs.
rarely involve the distal extremities.

Chondrosarcoma
Microscopic

These

tumors are composed of lobules of cartilage with anaplastic

chondrocytes in the lacunae and with focal enchondral ossification and
calcification.

Cartilage-forming Tumors;
Tumor Type

BENIGN

Osteochondroma

Chondroma

MALIGNANT

Chondrosarcoma

Locations

Age

Morphology

Metaphysis of long
tubular bones

10-30

Bony excrescences
with a cartilaginous
cap; may be solitary
or multiple and
hereditary

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

Bones of shoulder,
pelvis, proximal
femur, and ribs

40-60

Arise within
medullary cavity and
erode cortex;
microscopically well
differentiated
cartilage-like or
anaplastic

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.

Giant Cell Tumor

Gross

Giant Cell Tumor

Microscopic

METASTATIC BONE
TUMORS

Metastatic tumors are the most common

malignant tumor of bone.

Pathways of spread:

Origin:
The radiologic appearance of metastases