Bone tumors are more often caused by cancer that has spread to the bone from some other part of the body. Often, the combination of patients age and plain radiographic findings are sufficient for diagnosis and obviates the need. Welcome to our bone tumor pathology site bone tumors represent a unique group of pathologic conditions for which little time is assigned during the training period in most pathology residency programs. These include the thighbone femur, shinbone tibia, upper arm bone humerus and pelvis. Diagnosis of primary bone tumors with imageguided percutaneous biopsy. The advantage of radiographic technique is to collapse the density of all points in the imaging plane into a 2d image. Further work up including mri and biopsy revealed a chondrosarcoma. Tumors of the long bone may be benign or malignant. Bone tumor radiological approach linkedin slideshare. The most dramatic radiologic advances that have been made in the past couple of decades concern the staging evaluation of bone tumors. The aim is to study the radiological and pathological correlation of benign bone tumors. The imaging of bone tumors in the early 1970s relied heavily on radiographs. Tumors resulting from contiguous spread of adjacent soft tissue neoplasms tumors representing malignant transformation of the preexisting benign lesions. Radiography is the optimal initial imaging modality for evaluating undiagnosed primary bone tumors.
Cancers that start in the bones are called primary bone tumors. Prevent delay andor misdiagnosis of malignant lesions, and avoid tumor. Tumors of the hands and feet are benign in the great majority of cases, while those of the axial skeleton spine, pelvis, sternum, rib, scapula tend to be malignant. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes. This compact text aims to equip the reader with a pragmatic approach to imaging common and important bone lesions encountered in practice, including tumorlike lesions and tumor mimickers. Publicationdate 201101 in the article bone tumors differential diagnosis we discussed a systematic approach to the differential diagnosis of bone tumors and tumorlike lesions.
Evaluation of the margins is the greatest contributing factor to radiographic assessment of the biologic potential of the lesions. The classifications in common use are related more to the microscopic characteristics of the tumor and its presumed tissue of origin than to the radiographic. These include the thighbone femur, shinbone tibia, upper arm bone. Evaluation of the margins is the greatest contributing factor to. European journal of radiology imaging of a bone tumor. In the article bone tumors differential diagnosis we discussed a systematic approach to the differential diagnosis of bone tumors and tumorlike lesions.
Most bone tumors are benign, and unlikely to spread. Sclerotic bone tumors and tumorlike lesions 23012017 2112. Age tumor first and second decade nonossifying fibroma unicameral bone cyst aneurysmal bone cyst chondroblastoma langerhans cell histiocytosis osteosarcoma ewing sarcoma third through fifth. An awardwinning, radiologic teaching site for medical students and those starting out in radiology focusing on chest, gi, cardiac and musculoskeletal diseases containing hundreds of lectures, quizzes, handout notes, interactive material, most commons lists and pictorial differential diagnoses. The authors make use of highyield facts, differential diagnoses, and. A practical guide to imaging is a concise guide to common tumors encountered by physicians in daily practice. It is important to realize that the plain radiograph is the most useful examination for differentiating these. The atlas gives an overview of the diversity in the radiographic image of all malignant and benign bone tumors, and of many tumorlike bone lesions, by displaying some 1,500 illustrations chosen from more than 8,000 documented files from the netherlands committee on bone tumors which stress the typical and atypical features that would fit a. Bone tumors are a relatively uncommon and heterogeneous group of neoplasms of the skeleton, accounting for approximately 0. The most reliable indicator in determining whether these lesions are benign or malignant is the zone. Bone tumors and tumorlike conditions rsna publications online. Some types are more common in specific places such as the spine or near the growth plates of the largest bones. Benign bone lesions are a fairly common finding in radiology practice. An imaging approach to bone tumors musculoskeletal key.
The approach to the radiographic diagnosis of bone tumors consists of analyzing the lesion in an organized fashion, with attention to the specific radiographic features of tumor location, margins, and zone of transition. A periosteal reaction is a nonspecific reaction and will occur whenever the periosteum is irritated by a malignant tumor, benign tumor, infection or trauma. Bone cancers that start in another part of the body such as the breast, lungs, or colon are called secondary or metastatic bone tumors. Radiography is the single most helpful imaging modality when establishing the initial differential diagnosis of primary bone tumors. Confidently diagnose challenging musculoskeletal lesions with expert guidance. It is intended to have wide appeal to anyone dealing with bone lesions, especially radiology residents preparing for a musculoskeletal rotation or board.
Accuracy of ctguided biopsies in 359 patients with musculoskeletal lesions. The imaging features, with emphasis on standard radiography, allowing differentiation, of malignant bone tumors, will be highlighted. The most important determinators in the analysis of a potential bone tumor are. Bone scintigraphy bone scans could help stage the tumor, and angiography could help define it. Computed tomography ct and magnetic resonance imaging mri are indispensable in tumor staging for the following reasons. Radiologic and pathologic approach an accurate diagnosis of bone tumors requires a high level of skill on the part of both radiologist and pathologist. On closer inspection the calcification has a chondroid pattern of rings and curls. Imaging of bone tumors for the musculoskeletal oncologic surgeon. This website is created to introduce trainees in pathology to the basic concepts in diagnosis of bone tumors. Bone tumor systematic approach and differential diagnosis 23012017 2107. It is important to realize that the plain radiograph is the most useful examination for differentiating these lesions. Radiology of bone tumors free download as powerpoint presentation. The authors make use of highyield facts, differential diagnoses, and extensive radiological images to introduce a wide range of bone tumors, focusing on their classic. Apma 2018 radiology track bone tumors when to say gulp.
About us introductory course case studies unknoun slides. Evans, dpm, facfaom professor, department of podiatric medicine and radiology dr. The classifications in common use are related more to the microscopic characteristics of the tumor and its presumed tissue of origin than to the radiographic appearance of the lesion 4,5,9. They occur most often in young people between the ages of 10 and 20. This lecture is an introduction to musculoskeletal tumors. The approach to the radiographic diagnosis of bone tumors consists of analyzing the lesion in an organized fashion, with attention to the specific radiographic features of tumor location, margins, and. Radiologypathological correlation of primary benign bone. Bone tumors can affect any bone in the body and develop in any part of the bonefrom the surface to the center of the bone, called the bone marrow. Wu, md, is assistant professor of radiology at beth israel deaconess medical center, harvard medical school. Things that might make you more likely to get bone cancer include. An example of such a lesion is a chondroblastoma figs. Bone metastasis5 can also look like primary bone cancer.
Use imaging features to formulate a limited ddx and, perhaps, suggest a dx. Age tumor first and second decade nonossifying fibroma unicameral bone cyst aneurysmal bone cyst chondroblastoma langerhans cell histiocytosis osteosarcoma ewing sarcoma third through fifth decade giant cell tumor lymphoma parosteal osteosarcoma fourth decade and above metastasis myeloma chondrosarcoma chordoma lymphoma mfh table 2. In general, a widely accepted histopathological classification responds to the need of using reproducible diagnostic criteria and categories, which is a. Typical examples of benign and malignant bone tumors will be demonstrated, the various imaging modalities will be pictorial essay. A growing bone tumoreven a benign tumordestroys healthy tissue and weakens bone, making it more vulnerable to fracture. They are by far more common than primary bone tumors and are characterized by the following. The atlas gives an overview of the diversity in the radiographic image of all malignant and benign bone tumors, and of many tumorlike bone lesions, by displaying some 1,500 illustrations chosen from. These tumors are typically treated via curettage, and therefore additional imaging studies may be required preoperatively to assess the tumor. It discusses the classification and staging of benign and malignant musculoskeletal tumors. Metastatic cancers are the most frequent malignant tumors found in bone. Radiography in the initial diagnosis of primary bone tumors ajr.
Conventional radiography is usually the first step in the diagnostic. Most primary bone tumors are seen in patients in patients 30 years we must always include metastases and myeloma in the differential diagnosis. Bone tumors is an ideal resource for practicing physicians and residents in radiology, orthopedic surgery, pathology, and primary care. In general, a widely accepted histopathological classification responds to the need of using reproducible diagnostic criteria and categories, which is a prerequisite for the prediction of the biological potential of a tumor, thus finally representing a guide for treatment. Diagnostic imaging of primary bone tumors of the spine article pdf available in current radiology reports 57 may 2017 with 258 reads how we measure reads. Radiology and pathology correlation of bone tumors. A growing tumor may replace healthy tissue with abnormal tissue. Based on the lodwick classification an overview of the three main types of bone destruction patterns visible on radiographs will be given with many examples. Jul 16, 2014 the imaging of bone tumors in the early 1970s relied heavily on radiographs. Systematic approach and differential diagnosis 23012017 2107. Cancers that start in the bones are called primary bone. The role of chemotherapy in the treatment of bone and softtissue sarcomas pdf version. Best test for intraosseous extent and soft tissue extent. Bone tumors happen more often in people whove had radiation, stem cell.
Bone tumors clues and cues bone tumors clues and cues. The evaluation of bone tumors often requires more than one imaging modality, including radiography, bone scintigraphy, ct, mri and pet. Bone cancer early detection, diagnosis, and staging. Mohamed zaitoun assistant lecturerdiagnostic radiology department, zagazig university hospitals egypt finr. Radiography of bone tumors and tumorlike conditions. The differential diagnosis mostly depends on the age of the patient and the findings on the conventional radiographs. Benign tumors such as this lesion of the hand typically have cells with clear lacunar cytoplasms and small, dark, pinpoint nuclei. Percutaneous treatment of bone tumors by radiofrequency thermal ablation fernando ruiz santiago, maria del mar castellano garcia, luis guzman alvarez, jose luis martinez montes. Bone lesions are commonly encountered in pediatric patients, with primary bone tumors representing the 6th most common neoplasm. In this article there are links to other articles about bone tumors. Radiography in the initial diagnosis of primary bone tumors.
Pdf diagnostic imaging of primary bone tumors of the spine. Bone tumor imaging, then and now pubmed central pmc. Conventional radiography is usually the first step in the diagnostic process, representing an essential tool in the evaluation of the aggressiveness of the lesion and the response of the host bone. In this article we will discuss the differential diagnosis of sclerotic. Further work up including mri and biopsy revealed a. The role of chemotherapy in the treatment of bone and softtissue sarcomas pdf. Other modalities supplemented information gained by radiographs.
Tumors and tumorlike lesions of bone is aimed at general and specialised surgical pathologists, radiologists, orthopedic surgeons, and oncologists, in practice and in training. In the right iliac bone there is a subtle illdefined calcification. Bone tumors pdf bone tumors represent a unique group of pathologic conditions for which little. Diagnostic imaging of bone tumors linkedin slideshare. Imaging of malignant bone tumors archives in cancer research.
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