Bone Tumors Flashcards
How would you describe this bone lesion in an 11 y.o male?
What are the ddx?
Aggressive
DDX = Osteosarcoma, Ewing Sarcoma, Osteomyelitis (based on age differentiators)
What is the mnemonic for ddx for soap bubbly lesions?
FOGMACHINES
Fibrous dysplasia
Osteoblastoma
Giant cell tumor
Myeloma
Aneurysmal bone cyst
Chondroblastoma
Histocytosis X, hyperparathyroidism, hemophilia
Infection
Non-ossifying fibroma
Enchondroma
Simple bone cyst
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What are the 4 primary osteogenic benign tumors?
Osteoid Osteoma
Osteoblastoma
Osteoma
Enostoma
Consists of highly vascularized nidus of CT
Lucency (lucent nidus) less than 1 to 1.5cm in diameter surrounded by reactive sclerosis
Most commonly cortical based lesion
Most common locations: Femur, Tibia
Age of onset: 7-25
= what benign bone tumor
Osteoid Osteoma
Lucency with surrounding sclerosis (similar to osteoid osteoma though not as prominent)
Lucency typically larger than that seen with osteoid osteoma
Lucent nidus greater than 1.5-2cm
Eccentrically based medullary lesion
Located typically within the metaphysis or diaphysis
Second pattern: soap bubbly, expansile, lucent lesion
= what benign bone tumor
Osteoblastoma
Protrude from surface of bone
Most common locations: skull & sinuses
Mutiple lesions of this type is a feature of Gardner syndrome
Dense, well-define lesion, typically less than 2cm
Osteoma
What condition results in the appearnce of these radiographs?
AKA bone island
Focal region of sclerosis in medullary space
May be monostotic or polystotic
Most common locations: femur, pelvis, ribs (do not occur in skull)
= what benign bone tumor
Enostoma
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
2nd MC primary malignant bone tumor
Most common locations: femur, tibia and humerus (58% occur around knee)
3 basic patterns: Osteoblastic (50%), Osteolytic (25%), Mixed (25%)
Cortical disruption & periosteal reactions common (sunburst appearence & codman’s triangle common)
MC in metaphyseal region
= what aggressive bone tumor
Osteosarcoma
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
Tumor composed of masses of hyaline cartilage
Solitary, well defined, medullary based lucency
Endosteal scalloping
MC locations: Wrist & hand (over 50%), then femur, foot, humerus
MC benign tumor of the hand
Most commonly in metataphysis
= what benign cartilaginous tumor
Enchondroma
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
Characterized by multiple enchondromas
Metaphyseal based, commonly calcified
= ____ disease
Ollier
What condition results in the appearence of these radiographs?
Multiple enchondromas with soft tissue hemangiomas
Age of onset = less than 10
Shortened deformed bones
Unilateral distribution 50% of the time
= ____ syndrome
Maffuci
What condition results in the appearence of these radiographs?
AKA Codman’s tumor
Well defined often w/ thin sclerotic margin; occasionally may appear soap bubbly
Arises from cells of growth plate
MC locations = femur, humerus, tibia
Typically medullar based
= what benign cartilaginous tumor
Chondroblastoma
What condition results in the appearence of these radiographs?
Bony exostosis covered by hyaline cartilage; typically points away from nearby joint
May be pedunculated or sessile in shape
MC benign tumor of bone
= what benign cartilaginous tumor
Osteochondroma
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
Multiple osteochondromas
Bilateral distribution
Multiple pedunculated & sessile osteocondromas
May cause bayonet deformity of wrist/hand
= what condition
Hereditary Multiple Exostosis (if no hereditary component = osteochondromatosis)
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
3rd MC primary malignant tumor of bone
Two types: Cental & Peripheral
Osteolytic lesion w/ long zone of transition/poorly defined
Soft tissue mass often w/ calcification
Endosteum scalloping & bony expansion may be present
= what malignant cartilaginous tumor
Chondrosarcoma
What condition results in the appearence of these radiographs?
What condition results in the appearence of these radiographs?
Age of onset = 4-8
MC location = lower extremities
Well defined lucency, cortical based
Typically between 1-3 cm in size
Often demonstrates a thin rim of sclerosis
May have a soap bubbly appearance
MC metaphyseal in location
= what beningn fibrous tumor
Fibrous Cortical Defect (AKA Fibrous Xanthoma)
What condition results in the appearence of these radiographs?
Age of onset = 8-20
MC location = lower extremity
Lucent well defined lesion
Most commonly metaphyseal
Eccentrically located in medullary bone adjacent to/involving cortex
Greater than 3cm in size
Often demonstrate soap bubbly appearance
= what benign fibrous tumor
Non Ossifying Fibroma (AKA fibrous xanthoma)
What condition results in the apperance of these radiographs?
What condition results in the apperance of these radiographs?
Osteolytic lesion w/ poorly defined margins (long zone of transition)
Often large
Minimal to no periosteal reaction
Metaphyseal in location
Large soft tissue mass associated
MC medullary based
Age of onset = 25-55
= what aggressive fibrous tumor
Malignant Fibrous Histiocytoma
What condition results in the apperance of these radiographs?
What are the findings/ddx for this case of 18 YOM w/ knee pain for last 2 months
What are the findings/ddx for this case 65 YOF w/ neck pain for past several mo. with insidious onset
What are the findings/ddx for this case of 20 YOM w/ severe leg pain w/ redness & swelling
What are the findings/ddx for this case of 70 YOM w/ low back & right thigh pain
What are the findings/ddx for this case of 18 YOM w/ right sided low back pain of insidious onset
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
General & radiographic features of ____ include:
- Localized form of plasma cell myeloma
- Soap bubbly lucency (large in side, >4 cm)
- Expansile
Solitary Plasmacytoma
What pathology is shown here?
What pathology is shown here?
Radiographic findings of ___ include:
- Osteopenia
- Multiple well define lucencies (“punched out lesions”)
Multiple myeloma
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
Radiographic findings of ____ include:
- 60% of the time is polystotic
- Occurs in diaphysis in long bones
- 75% is lytic (permeative/motheaten)
- Common to demonstrate soft tissue masses
- DDx for ivory vertebra
Hodgkin lymphoma
Radiographic appearence for ____ includes:
- Typically permeative/motheaten
- Medullary based
- Minimal or absent periosteal reactions
- Commonly polystotic
Non-hodgkin Lymphoma
What pathology is shown here?
Radiographic findings of ___ include:
- Osteopenia
- Lucent metaphyseal bands
- Periostitis
- Lytic bone lesions
Childhood leukemia
Radiographic appearence of ___ includes:
- Expansile lucent lesion
- Soap bubbly appearance
- Eccentrically located in bone
- Cortical thinning
- Typically in the metaphysis
- Typically no periosteal reactions
Aneurysmal Bone cyst
What pathology is shown here?
Radiographic appearence of ____ includes:
- Predominately involves the vertebral body but may involve or extend into the neural arch
- Accentuated or prominent vertical trabecula within vertebral body (referred to as the corduroy cloth appearance)
- Bone appears more radiolucent surround the prominent vertical trabecula
Hemangioma
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
What pathology is shown here?
