Benign Tumors Flashcards
osteoma occurs in what type of bone
locations
membranous bones
outer skull and sinuses
how big is an osteoma
< 2cm
describe an osteoma on imaging
round, oval, well circumscribed
uniformly opaque
what is the mc benign tumor of the nose and paranasal sinuses
osteoma
what is gardners syndrome
multiple osteomas
and
colonic polyps
what does osteoma look like on MRI
low intensity on T1 and T2
where do bone islands occur
anywhere
mc in epiphysis and metaphysis
not diaphysis
also not seen in skull
what does bone island look like on imaging
discrete area of sclerosis
brush border - help ddx from blastic mets
round oval well circumscribed
long axis parallel to bone
what is a enostoma
another term for bone island
do bone islands cause any symptoms
no
no pain or chance of malignancy
what does bone island look like on MRI
how about CT
how about on bone scan
low intensity on T1 and T2
bright on CT
cold on bone scan unless in growth period
how big is an osteoid osteoma
< 1cm
osteoid osteoma most commonly occur where
in what part of the bone
mc in tibia or femur
also in neural arch
metaphysis
osteoid osteomas can induce what defect in the spine due to tumor in neural arch
painful rigid scoliosis
which tumor contains radiolucent nidus with surrounding sclerosis or solid periosteal reaction
osteoid osteoma
which tumor contains a vascular blush on MRI
osteoid osteoma
osteoid osteomas occur in what age range
10-25
what are the symptoms of osteoid osteoma
gradual onset of severe deep aching pain
worse at night!
relieved by aspirin!
what do you use to diagnose osteoid osteoma
CT
how do you treat osteoid osteoma
thermoregulation
what does osteoid osteoma show on bone scan
how about MRI
intense uptake
low signal
what is the differential diagnosis for osteoid osteoma
brodies abscess
- infection (osteomyelitis) with same signs and symptoms but NO vascular blush and nidus > 1cm
osteoid osteoma is < 1cm
also brodies is cold on bone scan to differentiate
where does osteoblastoma occur
common in metaphysis
but loves posterior neural arch
what does osteoblastoma look like on imaging
expansile lesion
egg shell thin cortex and matrix
maybe sclerotic
what is the age range for osteoblastoma
10-20
what are the symptoms of osteoblastoma
gradual onset of pain
painful scoliosis if in posterior neural arch
pain not relieved by aspirin and not worse at night (compared to osteoid osteoma)
what ROM is lost in osteoblastoma
loss of extension
what is the differential diagnosis for osteoblastoma
ABC
can osteoblastomas become malignant
small percentage do
what does osteoblastoma look like on bone scan
how about MRI
HOT
high intensity on T2 due to increase fluid
what is the treatment for osteoblastoma
curettage
radiation if last resort
where does solitary enchondromas occur in the body
common in metaphysis
loves small bones of hands and feet
what do solitary enchondromas look like on imaging
radiolucent expansile lesions
intact but thinning of the cortex
endosteal scalloping
punctate calcification
what may have happened if solitary enchondroma is causing pain
pathological fracture or malignant transformation
usually doesnt cause pain
if enchondroma becomes malignant, where is it located
axial skeleton
turns into chondrosarcoma when metastasizes
what age does solitary enchondromas occur in
10-30
what does solitary enchondroma look like on MRI
low signal
what is treatment of solitary enchondroma
what about if fracture occurs
what if its close to axial spine
packing chips - calcium phosphate packing
implanted human bone morphogenic protein
fracture - casting and curettage
axial spine = malignant - prophylactic surgery to remove
multiple enchondromas is called
olliers disease
are solitary or multiple enchondromas more likely to become malignant
multiple - olliers
10-50%
multiple enchondromas, hemangiomas, and phleboliths is called what
maffuccis syndrome
does solitary enchondromas, olliers, or maffuccis have the highest rate of malignancy transformation
maffuccis syndrome
multiple enchondromas, hemangiomas, phleboliths
transforms into chondrosarcoma
where do chondroblastomas occur
only epiphysis and apophysis
knees, femur, proximal tibia, and humerus
what does chondroblastoma look like on imaging
radiolucent round oval lytic lesion
eccentric - located in medullary canal
internal matrix calcification because cartilaginous matrix
ring of sclerosis
solid periosteal reaction
what age do chrondroblastoma occur in
10-25
what is also called codmans tumor
chondroblastoma
what is the treatment chondroblastoma
curettage and bone chip packing
what does chondroblastomas look like on MRI
what does it look like on bone scan
low signal
hot!
what is the size of chondromyxoid fibroma
1-10 cm
chondromyxoid fibroma looks __ but it is actually __
look malignant
but its benign
chondromyxoid fibroma occurs in what location MC
proximal 1/3 of tibia
what does chondromyxoid fibroma look like on imaging
eccentric oval round lesion
endosteal scalloping
sclerosis on the medullary side of lesion
trabeculated or soap bubble appearance
what age group does chondromyxoid fibroma occur in
10-30
or
50-70
what is treatment for chondromyxoid fibroma
curettage or excision
where do fibrous cortical defects MC occur
posterior medial distal femur**
or LE
metaphysis
what does fibrous cortical defect look like on imaging
< 1cm
lytic lesion
sclerotic rim
eccentric
what age range does fibrous cortical defect occur in
4-8
fibrous cortical defect is symptomatic or asymptomatic
asymptomatic - found by accident
fibrous cortical defect may become what
non ossifying fibroma
non ossifying fibroma MC occurs where
MC in distal tibia
diametaphyseal
what does non ossifying fibroma look like
2-7 cm
multilocular
lytic eccentric ovoid
dense sclerotic border on medullary side of lesion
- peripheral sclerotic border
periosteal reaction
what age range does non ossifying fibroma occur in
8-20