Deck 13: Bone Tumors and Related Diseases

Question 1

Which of the following parameters is not used in the TNM system of staging tumors?

A) Tumor matrix composition
B) Size of the tumor
C) Lymph node involvement
D) Metastasis to other regions of the body

Answer 1

Tumor matrix composition

Question 2

Osteosarcomas commonly arise from the metaphysis of the __________.

A) distal humerus and proximal radius
B) distal femur and proximal tibia
C) proximal ulna
D) distal fibula

Answer 2

distal femur and proximal tibia

Question 3

The most common radiographic manifestation of childhood leukemia is __________.

A) osteosclerotic bone lesions
B) multiple ivory vertebra
C) subchondral cysts
D) generalized osteopenia

Answer 3

generalized osteopenia

Question 4

Leukemia may cause a separation of the skull sutures in a small percentage of pediatric patients, as well as periostitis. A differential diagnosis for this radiographic appearance should also include __________.

A) osteoid osteoma
B) neuroblastoma metastasis
C) multiple myeloma
D) bronchogenic carcinoma metastasis

Question 5

Which of the following is a pedunculated or sessile benign outgrowth of bone covered by a cartilaginous cap?

A) Chondroblastoma
B) Chondromyxoid fibroma
C) Enchondroma
D) Osteochondroma

Question 6

Which of the following conditions comprises unilateral polyostotic fibrous dysplasia, precocious puberty, and cutaneous hyperpigmentations (café au lait spots)?

A) McCune-Albright syndrome
B) Mazebraud syndrome
C) Cushing syndrome
D) Jaffe-Campanacci syndrome

Question 7

Congenital shortening of the ulna and outward bowing of the radius are referred to as __________.

A) Bayonet deformity
B) Maffucci syndrome
C) Shepherd crook defect
D) Ollier disease

Question 8

What is the most common benign skeletal neoplasm?

A) Multiple myeloma
B) Chondroblastoma
C) Simple bone cyst
D) Osteochondroma

Question 9

Hodgkin disease is a form of lymphoma that can be separated from non-Hodgkin lymphoma by the presence of the __________.

A) Reed-Sternberg cells
B) Bence Jones proteins
C) transmetaphyseal lucent bands
D) subchondral cysts

Question 10

What is the most common tumor of the phalanges?

A) Enchondroma
B) Chondromyxoid fibroma
C) Chondroblastoma
D) Osteochondroma

Question 11

Which of the following is more characteristic of a malignant as opposed to a benign lesion?

A) Small size
B) Slow growth rate
C) Wide zone of transition
D) Peripheral sclerotic rim

Question 12

Which of the following laboratory results strongly suggests a diagnosis of leukemia?

A) An increased complete blood count
B) Finding of blast cells in the peripheral blood smear
C) A normal complete blood count
D) Increased serum calcium

Question 13

A rare, benign cartilaginous bone tumor typically found within an epiphysis or apophysis in the knee that is more common in male patients ages 5-25 is __________.

A) chondromyxoid fibroma
B) chondroblastoma
C) aneurysmal bone cyst
D) fibrous dysplasia

Question 14

What is the third most common malignant primary bone tumor?

A) Osteosarcoma
B) Aneurysmal bone cyst
C) Giant cell tumor
D) Chondrosarcoma

Question 15

Which of the following is a metadiaphyseal, permeative, osteolytic lesion with aggressive periosteal changes and saucerization of the cortex that is found in patients younger than 30 years of age?

A) Multiple myeloma
B) Ewing sarcoma
C) Metastatic bone disease
D) Giant cell tumor

Question 16

Which of the following conditions is marked by the presence of multiple osteochondromas?

A) Multiple myeloma
B) Hereditary multiple exostosis
C) Polyostotic fibrous dysplasia
D) Osteopoikilosis

Question 17

Which of the following is a primary malignant bone tumor commonly found in the pelvis, proximal femur, and proximal humerus, in patients between ages 50 and 70?

A) Osteosarcoma
B) Chondroblastoma
C) Chondrosarcoma
D) Osteoid osteoma

Question 18

All of the following are typical lab findings with multiple myeloma except __________.

A) decreased serum calcium levels
B) Bence Jones proteins in the urine
C) "M spike" with protein electrophoresis
D) reversed A/G serum ratio

Question 19

What is the most common primary malignant tumor of bone?

A) Osteosarcoma
B) Chondrosarcoma
C) Multiple myeloma
D) Ewing sarcoma

Question 20

Classically, which of the following clinical features represents a "red flag" for aggressive bone disease?

A) More dramatic pain in the morning
B) Increased pain with physical activity
C) Increased mobility
D) Cachexia

Question 21

Which of the following tumors is least likely to be found in the diaphysis?

A) Ewing sarcoma
B) Multiple myeloma
C) Malignant fibrous histiocytoma
D) Giant cell tumor

Question 22

A lipoma is a common, benign collection of mature fat cells most often found in the __________.

A) spine
B) calcaneus
C) skull
D) clavicle

Question 23

A soap bubbly saccular protrusion from the cortex of a long bone describes a(n) __________.

A) hemangioma
B) simple bone cyst
C) aneurysmal bone cyst
D) Ewing sarcoma

Question 24

Metastatic lesions become radiographically apparent when __________ of the bone is destroyed.

A) 0% to 10%
B) 30% to 50%
C) 70% to 90%
D) 5% to 25%

Question 25

Which of the following radiographic features indicates bony fragments in the gravity-dependent fluid of a simple bone cyst?

A) Rind sign
B) Fallen fragment sign
C) Shepherd crook deformity
D) Bayonet deformity

Question 26

Which lesion may cross the intervertebral disc to involve adjacent segments?

A) Hemangioma
B) Giant cell tumor
C) Aneurysmal bone cyst
D) Chordoma

Question 27

Where are 90% of simple bone cysts found?

A) The proximal tibia and fibula
B) The distal radius and ulna
C) The proximal humerus and femur
D) The distal metacarpals

Question 28

What is the most common benign tumor of the spine?

A) Osteoid osteoma
B) Chondroblastoma
C) Hemangioma
D) Simple bone cyst

Question 29

A rare, radiolucent lesion that histologically mimics embryonal enamel and most commonly occurs in the molar regions of the mandible is a(n) __________.

A) epidermoid cyst
B) interosseous ganglion cyst
C) adamantinoma
D) ameloblastoma

Question 30

Two thirds of patients with a simple bone cyst seek clinical attention because of __________.

A) a local soft-tissue mass
B) a "locked" joint
C) a pathological fracture
D) hemoptysis

Question 31

In adults, all of the following locations are common for metastasis except __________.

A) carpals
B) liver
C) pulmonary tissues
D) spine

Question 32

What is the term for a lateral bowing and coxa vara deformity occurring in the proximal femur secondary to remodeling of pathological microfracture?

A) Cherubism
B) Mazebraud syndrome
C) Shepherd crook deformity
D) McCune-Albright syndrome

Question 33

Which location is the least likely for a chordoma?

A) Sacrococcygeal
B) Clavicle
C) Spheno-occiput
D) C2 vertebral body

Question 34

Which lesion is associated with the formation of a "one-eyed" vertebra?

A) Giant cell tumor
B) Simple bone cyst
C) Hemangioma
D) Metastatic bone disease

Question 35

Among men and women, where does the most common carcinoma to metastasize to bone originate?

A) Thyroid
B) Lung
C) Brain
D) Colon

Question 36

An ivory vertebra may be seen with __________.

A) aneurysmal bone cyst
B) metastasis
C) multiple myeloma
D) osteosarcoma

Question 37

Which of the following statements best characterizes liposarcoma?

A) It is the most common soft tissue sarcoma.
B) It is most commonly found in children.
C) It is commonly located in the buttocks, thigh, calf, and retroperitoneal tissues.
D) It is often symptomatic during early stages by mostly causing joint stiffness.

Question 38

Which of the following procedures involves the use of hand instruments to gently remove medullary bone?

A) Amputation
B) Immunotherapy
C) Curettage
D) Bone grafting

Question 39

Select the lesion most likely to occur in a child.

A) Metastatic bone disease
B) Multiple myeloma
C) Chondrosarcoma
D) Ewing sarcoma

Question 40

A rare, benign, inflammatory disorder of the synovial membranes of joints, bursae, and tendon sheaths best describes the following:

A) Synoviosarcoma
B) Rhabdomyosarcoma
C) Synoviochondrometaplasia
D) Pigmented villonodular tenosynovitis

Question 41

Radiographs of the knee of a 38-year-old male patient complaining of "locking" of the joint show multiple radiodense loose bodies noted in the confines of the joint capsule, pressure erosions, widened joint space, and secondary degeneration. Which of the following is the most likely diagnosis?

A) Pigmented villonodular synovitis
B) Hydroxyapatite deposition disease
C) Synovial chondromatosis
D) Rice bodies of rheumatoid arthritis

Question 42

Negative bone scans due to suppressed osteoblastic activity are common with which of the following diagnoses?

A) Leukemia
B) Lytic metastasis
C) Blastic metastasis
D) Multiple myeloma

Question 43

Which of the following tumors is most likely to be found in the soft tissues of a 65-year-old patient who has previously undergone radiation therapy to the area?

A) Myositis ossificans
B) Multiple myeloma
C) Malignant fibrous histiocytoma
D) Osteoblastoma

Question 44

Which of the following is the best diagnosis for a lesion in the mandible of a 30-year-old female patient that initially presented as a radiolucent region that stabilized and became sclerotic over time?

A) Ossifying fibroma
B) Nonossifying fibroma
C) Adamantinoma
D) Fibrous dysplasia

Question 45

Multiple osteolytic lesions with sclerotic margins are noted within the pelvis and long bones of the left lower extremity in a 9-year-old female. The patient's skin shows café-au-lait spots with irregular borders. What signal intensity is likely to be observed on MRI examination of the bone lesions?

A) Low on T1, low on T2
B) Low on T1, high on T2
C) High on T1, low on T2
D) High on T1, high on T2