There is a benign, well circumscribed tumor within the medullary cavity. The treatment of choice is local curettage. Amputation such as this is overtreatment. The commonest site for an osteoid osteoma is the upper end of the tibia.
Osteoid osteoma proximal phalanx of a finger
Osteoid osteoma
Osteoid osteoma of talus. Note the small central osteolytic nidus surrounded by dense bone (arrow)The small, reddish central nidus is surrounded by a thick layer of sclerotic bone.
Osteoid osteoma
LP microscopic view showing a wedge-shaped nidus protruding slightly above the surface and surrounded by sclerotic bone.This is the central nidus of an osteoid osteoma composed of irregular reactive new bone.
Lateral radiograph of elbow with osteoblastoma of distal humerus. Predominantly lytic expansile lesion with associated surrounding reactive sclerosis.
Osteoblastoma
The creamy tumor has involved the lower end of the femur and has broken through the cortical bone and caused elevation of the periosteum.
Osteosarcoma
Osteosarcoma femur
The tumor is located at the classic metaphyseal site and is largely restricted to boneThe tumor is located at the classic metaphyseal site and is accompanied by massive soft tissue extension.
The tumor is being temporarily restrained by the cartilage of the epiphyseal line. The hemorrhagic area represents the biopsy site.
Osteosarcoma upper tibial metaphysis
The neoplastic spindle cells of osteosarcoma are seen to be making pink osteoid here. Osteoid production by a sarcoma is diagnostic of osteosarcoma.
Osteosarcoma
There are characteristic basophilic thin trabeculae of neoplastic bone (lace-like) with an appearance that is reminiscent of fungal hyphae. Note the malignant background cells with mitotic activity (arrow).
Osteosarcoma
Coarse, lacelike pattern of neoplastic bone (arrow) produced by anaplastic tumor cells. Note the wildly aberrant mitotic figures (arrowheads).
osteosarcoma
This is an osteochondroma of bone. This lesion appears as a bony projection (exostosis). Most are solitary, incidental lesions that may be excised if they cause local pain. There is a rare condition of multiple osteochondromatosis marked by bone deformity and by a greater propensity for development of chondrosarcoma.
Osteochondroma bone
Large osteochondroma of femur with a bilobed appearance.
Osteochondroma boneCut surface of osteochondroma of rib. Note the thick cartilaginous cup
Gross and whole-mount appearance of osteochondroma. Mature bone is covered by a well-differentiated cartilaginous cap.
Osteochondroma bone
whole-mount appearance of osteochondroma. Mature bone is covered by a well-differentiated cartilaginous cap
Osteochondroma bone
This small cartilage tumour was resected from the tibia. Note the gray-blue, translucent appearance.
Chondroma
Chondroma: Olleir’s disease Gross appearance of head of humerus affected by multiple chondromas in a patient with Ollier's disease.
The tumor produces a semispherical expansion of the involved bone.
Juxtacortical chondromaEnchondroma of phalanx. The tumor has a typical lobulated appearance.
ChondromaTypical chondrosarcoma of femur showing splotchy calcification and extensive cortical destruction.
Chondrosarcoma
Gross appearances of central chondrosarcoma: A to D, all of these tumors were located in the femur, the single most common site of occurrence. Islands of cartilage (gray-blue glistening masses) expand the medullary cavity and grow through the cortex to form a sessile paracortical mass in D (see next). In C& D the tumors show prominent cystic degeneration.
Central chondrosarcoma
A
B
Central chondrosarcoma femur
CD
Gross appearances of central chondrosarcoma: of rib, resulting in massive expansion of the bone.
Central chondrosarcoma rib
Large expansile chondrosarcoma of sternum.
Chondrosarcoma sternumAnaplastic chondrocytes within a chondroid matrix.
ChondrosarcomaMetaphyseal fibrous defect/nonossifying fibroma
Metaphyseal fibrous defect of lower end of tibia. Note its sharp delineation and sclerotic margins.Large non-ossifying fibroma expanding lower tibial metaphysis.
Characteristic storiform pattern of spindle cells interspersed with scattered osteoclast-type giant cells.Fibrous cortical defect or nonossifying fibroma.
Metaphyseal fibrous defect. The predominant element is a spindle cell of fibroblastic appearance. There are also irregularly scattered osteoclasts.
Metaphyseal fibrous defect/nonossifying fibroma
Microscopic appearances of metaphyseal fibrous defect involving the upper metaphysis of the tibia.
Fibrous dysplasia
Lesion of tibia forming a sharply delimited lesion.Lesion of the rib. It forms a fusiform, expanded mass that is grayish white.
Fibrous dysplasiaCurved trabeculae of woven bone arising in a fibrous tissue. Note the absence of osteoblasts rimming the bones.
Fibrous dysplasia
Typical low-power appearance of fibrous dysplasia.
Fibrous dysplasia4-year-old girl with large, dark lesions with serpiginous borders in chest, neck, back (cafe-au-lait skin pigmentation). Cast due to fractures
Fibrous dysplasia: Albright syndrome
This primary bone tumor mainly occurs in the diaphysis of long bones of children and young adults. There is a slight male predominance. This diaphyseal tumor mass is breaking through the cortex with foci of necrosis & hemorrhage. More normal fatty marrow is seen at the right.
Ewing sarcoma
A large tumor in the upper third of the tibia has eroded the cortical bone and extended beneath the periosteum.
Ewing sarcoma
Ewing sarcoma
A tumor involving the distal clavicle; it is a medullary tumor that has destroyed the cortex & extend into the surrounding soft tissue. The radiograph shows a highly permeative & destructive process with the formation of a large soft tissue mass.Sheets of small round cells with scant, cleared cytoplasm (PAS positive).
Ewing sarcomaEwing's sarcoma contains abundant glycogen, as seen by the reddish granular cytoplasmic staining by PAS stain here.
Ewing sarcoma
Giant cell tumor bone
Typical radiograph of giant cell tumor of distal end of femur involving epiphysis and metaphyseal area. The lesion was resected surgically.Giant cell tumor of lower end of femur
Gross appearance of giant cell tumor of lower end of femur. The lesion is characteristically peripheral, expansile, well circumscribed, and hemorrhagic.The lesion, which has a very hemorrhagic quality, has destroyed the cortex and extended into the adjacent soft tissues.
Benign giant-cell tumor showing abundant multinucleated giant cells and a background of mononuclear cells.
Giant cell tumor of bone (osteoclastoma)
This section of vertebral bone from autopsy demostrates multiple foci of pale irregular metastases. The most common neoplasm in bone is a metastasis. A closer view of bone metastases. Virtually all bone metastases are from carcinomas.
Metastatic carcinoma vertebrae G
Microscopic appearance. The optically clear appearance of the cytoplasm, rich vascularity & extensive hemorrhage are characteristic features.
Metastatic renal cell carcinoma bone
Here is a microscopic view of metastases to bone. Such areas appear as "hot spots" on radiographic scans. If the bone is markedly weakened by the metastasis, then a "pathologic" fracture is possible.
At high magnification, metastatic infiltrating ductal carcinoma of breast is seen within bone and filling the marrow cavity. There is reactive new bone with pale pink osteoid being laid down next to a bony spicule at the upper left.
Metastatic breast ca to bone