bone

1. Bone tumors

2. Classification
1. Primary
2. Metastatic -3rd
common site of
hematogenous metastasis
 Liver >Lungs > Bone

3. Primary Bone tumors
 Osseous tumors
 Non Osseous Tumors

4. Osseous tumors

5. Benign Malignant
Bone
forming/osteoblastic
Osteoma
Osteod osteoma
Osteoblastoima
Osteosarcoma
Cartilage forming Enchondroma
Osteochondroma
Chondroblastoma
Chondrosarcoma
Hematopoietic Myeloma
Lymphoma
Unknown Giant Cell tumor Malignant GCT
Ewing’s sarcoma
Notochordal Chordoma

6. Non Osseous Tumors

8. Vascular Hemangioma Hemangio
endothelioma
Pericytoma
Fibrogenic Non ossifying
fibroma
Fibrosarcoma
Neurogenic Neurilemmoma
Shwannoma
MPNST
Lipogenic Lipoma Liposarcoma
Histiocytic Fiberous
histiocytoma
Malignant Fibrous
Histiocytoma

11.  Gardner syndrome, also known as familial
colorectal polyposis,[1] is an autosomal
dominant form of polyposis characterized by
the presence of multiple polyps in the colon
together with tumors outside the colon.[2] The
extracolonic tumors may include osteomas of
the skull, thyroid cancer, epidermoid cysts,
fibromas and sebaceous cysts,[3] as well as
the occurrence of desmoid tumors in
approximately 15% of affected individuals.

15. Osteosarcoma
 MC primary tumor of bone
 Tumor cells can produce osteiod – tumor ostiod /
tumor bone
 Malignancy of mesenchyme
 Two types
1. Central / medullary
2. Surface / parosteal / Perosteal
 Pathogenesis
1. Primary
2. Secondary

16. Pathogenesis
 Genetic
 Constitutional factors
 Environmental Factors

17. Genetic
 RB gene mutation – 1000 times more risk
 13q14
 Homozygous mutation in RB locus
 Mutation in p53 gene
 Over expression of MDM2

18. Constitutional factors
 10- 20 yrs – maximum Bone growth
 Males more risk – inc osteoblastic activity
 Inc risk in paget’s disease
 Metaphysis - osteogenesis

19. Pathogenesis
 Metaphysis
 Medullary cavity
 Perisoteal eleation – codmann’s triangle
 Xray – metaphyseal radio dense lesion with
codmann’s triangle
 Sunburst / sunray appearance

20. Gross
 Fleshy tumor
 Expands laterally

26. Microscopy
 Tumor cells– very in shape –giant cells-
spindle ,oval polgonal cells
 Osteiod – not rimmed by osteoblast
 But surrounded by tumor cells
 Varients –
1. Chondroblastic
2. Fibroblastic
3. Small cell
4. telangectactic

27. Chondroblastic osteosarcoma
 Mandible can be
involved

28. Fibroblastic Osteosarcoma

29. Small cell osteosarcoma

30. Telangectatic

31. T/t
 Limb salvaged surgery

32. Extra skeletal osteosarcoma
 Mediastinum
 Breast
 retroperitonim

33. Surface Osteosarcoma
1. Parosteal / Juxta cortical Osteosarcoma
2. Periosteal osteosarcoma

34. Ewing’s sarcoma
 Highly malignant small round cell tumor
 More in females
 5 – 20 yrs
 Cell of origin – Primitive Neurectodermal cells

35. Variants of ES
1. Classic / Skeletal ES
2. Soft tissue Ewing’s sarcoma
3. PNET