B&J Week 6 Material
B&J Week 6 Material
• MOCE
• The most common malignant primary bone tumors, ordered most to least
common
• Multiple myeloma
• Osteosarcoma
• Chondrosarcoma
• Ewing’s sarcoma
• Multiple myeloma
• AKA plasma cell myeloma
• Overproduction of IgG
• Most common primary malignancy of bone
• Affects older people
• Clinical presentation:
• Most common presenting symptom:
• Bone pain (70%)
• Most common cause of death:
• Bacterial infection
• Second most common cause of death:
• Renal failure
• Associated with pathological fractures
• Name signs:
• Punched-out lesions
• Affects the medullary cavity
• Raindrop skull
• Multiple punched-out lesions of the skull
• Lab:
• Reversed A/G ratio is the hallmark finding
• Where A is albumin and G is “globulin” - i.e. immunoglobulin -
i.e. IgG
• M-protein spike
• Bence-jones proteinuria
• Anemia
• Hypercalcemia
• Osteosarcoma
• Tumor of mesenchymal cells (in the medullary cavity)
• Causes the direct formation of osteoid (blastic tumor)
• Second most common (just use MOCE)
• Affects younger people
• X-ray
• Most common site = metaphysis of long bones
• Lab
• Elevated alkaline phosphatase
• Chondrosarcoma
• Malignant tumor arising from cartilage
• Most commonly affects pelvis and femur
• Affects older people
• X-ray:
• Endosteal scalloping
• Looks like scallops inside the bone (cortex eaten from within)
• Mottled calcification of the tumor matrix
• Laminated or spiculated periosteal response
• Ewing’s sarcoma
• Tumor of primitive stem cells
• Affects younger people (10-20 yo)
• Most commonly affects the diaphysis
• Appears like an infection (redness and swelling)
• X-ray
• Lytic and sclerotic lesions
• Cortical saucerization
• from tumor extension into the haversian system subperiosteally
• Name sign:
• Onion skin periosteum
• Laminated periosteal response
• Chondrosarcoma also has laminated response