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BONE TUMORS By Dr. Ahmed Hosny.

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Presentation on theme: "BONE TUMORS By Dr. Ahmed Hosny."— Presentation transcript:

1 BONE TUMORS By Dr. Ahmed Hosny

2 Clues by Appearance of Lesion
Clues by Location of Lesion Clues by Density of Lesion Other Clues

3 Clues by Appearance of Lesion
Patterns of Bone Destruction Periosteal Reactions Tumor Matrix Expansile Lesions of Bone

4 Clues by Appearance of Lesion
Patterns of Bone Destruction Geographic Moth-eaten Permeative

5 Geographic Bone Destruction
Destructive lesion with sharply defined border Implies a less-aggressive, more slow-growing, benign process Narrow transition zone

6 Patterns of Bone Destruction
Geographic Moth-eaten Permeative Non-ossifying fibroma

7 Geographic Bone Destruction
Examples: Non-ossifying fibroma Chondromyxoid fibroma Eosinophilic granuloma

8 Moth-eaten Bone Destruction
Areas of destruction with ragged borders Implies more rapid growth Probably a malignancy

9 Patterns of Bone Destruction
Geographic Moth-eaten Permeative Multiple Myeloma

10 Moth-eaten Bone Destruction
Examples: Myeloma Metastases Lymphoma Ewing’s sarcoma

11 Permeative Bone Destruction
Ill-defined lesion with multiple “worm-holes” Spreads through marrow space Wide transition zone Implies an aggressive malignancy Round-cell lesions

12 Patterns of Bone Destruction
Geographic Moth-eaten Permeative Leukemia

13 Permeative Bone Destruction
Examples: Lymphoma, leukemia Ewing’s Sarcoma Myeloma Osteomyelitis Neuroblastoma

14 Patterns of Bone Destruction
Geographic Moth-eaten Permeative Less malignant More malignant

15 Periosteal Reactions Benign More aggressive or malignant None Solid
Lamellated or onion peel Sunburst Codman’s triangle

16 Periosteal Reactions Benign Aggressive/malignant None Solid onion-peel
Sunburst Codman’s triangle Non-ossifying fibroma

17 Periosteal Reactions Benign Aggressive/malignant Chronic osteomyelitis
None Solid Aggressive/malignant onion-peel Sunburst Codman’s triangle Chronic osteomyelitis

18 Periosteal Reactions Benign Aggressive/malignant None Solid onion-peel
Sunburst Codman’s triangle Ewing sarcoma

19 Periosteal Reactions Benign Aggressive/malignant Osteo-sarcoma None
Solid Aggressive/malignant onion-peel Sunburst Codman’s triangle Osteo-sarcoma

20 Periosteal Reactions Benign Aggressive/malignant Osteo-sarcoma None
Solid Aggressive/malignant onion-peel Sunburst Codman’s triangle Osteo-sarcoma

21 Periosteal Reactions Solid Sunburst onion-peel Codman’s triangle
Less malignant More malignant

22 Tumor Matrix Osteoblastic Fluffy, cotton-like or cloud-like densities
Osteosarcoma Cartilaginous Comma-shaped, punctate, annular, popcorn-like Enchondroma, chondrosarcoma, chondromyxoid fibroma

23 Tumor Matrix Osteoblastic Cartilaginous

24 Tumor Matrix Cartilaginous
Osteoblastic Fluffy, cotton-like or cloud-like densities as Osteosarcoma Cartilaginous Comma-shaped, punctate, annular, popcorn-like as Enchondroma, chondrosarcoma, chondromyxoid fibroma

25 Tumor Matrix Osteoblastic Cartilaginous Chondrosarcoma

26 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

27 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

28 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Renal cell carcinoma

29 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

30 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

31 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

32 Expansile Lesions of Bone
Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia

33 Clues by Location of Lesion
In the Transverse Plane In the Longitudinal Plane Characteristic Locations by tumors Characteristic Tumors by Body Site Pelvic Lesions Expansile Rib Lesions Lesions of the Spine

34 In the Transverse Plane
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35 In the longitudinal Plane
Epiphyseal GCT, chondroblastoma Metaphyseal Osteomyelitis, osteo-and chondrosarcoma Diaphyseal Round cell lesions, ABC, enchondroma

36 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

37 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

38 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

39 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

40 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

41 Characteristic Locations
Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior

42 Clues by Density of Lesion
Sclerotic Cortical Lesions Lytic Lesions in Children Lytic Lesions in Adults Blastic Lesions in Children Blastic Lesions in Adults

43 Sclerotic Cortical Lesions
Osteoid osteoma Brodie’s abscess

44 Sclerotic Cortical Lesions
Osteoid osteoma Brodie’s abscess

45 Lytic Lesions in Children
Eosinophilic granuloma Leukemia

46 Lytic Lesions in Children
Eosinophilic granuloma Leukemia

47 Lytic Lesions in Adults
Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor Metastatic thyroid carcinoma

48 Lytic Lesions in Adults
Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor

49 Lytic Lesions in Adults
Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor Chondrosarcoma

50 Blastic Lesions in Children
Lymphoma

51 Blastic Lesions in Adults
Metastatic disease Breast –female Prostate –male Lymphoma Paget’s disease Fluorosis Prostatic Ca.

52 Blastic Lesions in Adults
Metastatic disease Breast –female Prostate –male Lymphoma Paget’s disease Fluorosis

53 Blastic Lesions in Adults
Metastatic disease Breast –female Prostate –male Lymphoma Paget’s disease Fluorosis

54 Blastic Lesions in Adults
Metastatic disease Breast –female Prostate –male Lymphoma Paget’s disease Fluorosis

55 Other Clues Soft Tissue Extension Benign vs. Malignant

56 Soft Tissue Extension Usually implies malignancy
More likely to form discrete soft tissue mass Benign conditions with soft tissue extension Osteomyelitis Usually infiltration of fat

57 Soft Tissue Extension lymphoma

58 Benign vs. Malignant

59 Thank You


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