| >> Benign Bone Tumors |
Unicameral Bone Cyst
- Age distribution: first two decades
- Presentation: majority are asymptomatic but can present with pain if fractures
- Location: most frequently involve the proximal humerus, proximal femur, proximal tibia
- Treatment: usually observation, apply cast or splint if fractures, if symptomatic or likely to fracture, fill-in with synthetic bone matrix or bone graft
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Nonossifying Fibroma
- Age distribution: first two decades
- Presentation: asymptomatic, typically an incidental finding, pain if small fracture
- Location: ends of long bones, e.g. distal femur, tibia
- Treatment: usually observation, apply cast or splint if fractures, if symptomatic or likely to fracture, fill-in with synthetic bone matrix or bone graft
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Aneurysmal Bone Cyst
- Age distribution: second decade
- Presentation: dilated, blood filled cavity causing pain of short duration, swelling may be present
- Location: ends of long bones, femur and tibia are most common long bones, posterior elements of the spine,
- Treatment: curettage, possible cryosurgery and internal fixation
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Enchondroma
- Age distribution: variable
- Presentation: usually asymptomatic, up to 30% may present with pathological fracture, especially in the hands and feet
- Location: most common primary bone tumor of the hand
- Treatment: Observation, however when symptoms occur in areas other than hands/feet, secondary chondrosarcoma must be ruled out and curettage is usually performed
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Osteochondroma
- Age distribution: <20 years old, male to female ratio = 3:1, most common benign bone tumor
- Presentation: asymptomatic, if painful, usually due to secondary: bursitis, mechanical irritation or fracture through stalk
- Location: 40% occur around the knee
- Treeatment: observation, if painful, need to rule out malignant transformation
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Fibrous Dysplasia
- Age distribution: usually present by age 10
- Presentation: usually asymptomatic but can present with bone pain, usually due to small fractures, large lesions can cause bony deformities,
McCune - Albright’s syndrome: multiple fibrous dysplasia with “Café au lait” skin spots, lesions cease growth at puberty, but may change during pregnancy, also has associated hormonal disturbances
- Location: Metaphyseal or diaphyseal lesions, Common in femur, tibia, skull, ribs
- Treatment: Observation, surgery for painful lesions
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Chondroblastoma
- Age distribution: second decade, male:female ratio = 2-3:1
- Presentation: pain, occasionally joint inflammation
- Location: ends (epiphyses) of bones, especiially hip and shoulder
- Treatment: curettage of tumor and filing of defect with bone cement and metal plates/screws
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Giant Cell Tumor
- Age distribution: 20-50 years old
- Presentation: pain, tenderness, swelling in involved area, limited range of motion
- Location: most common around the knee (55%), also wrist, sacrum, hands & feet
- Treatment: curettage of lesion with phenol (alcohol) used to reduce risk of recurrence, filling of defect with cement and metal plates/screws
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