Download presentation
Presentation is loading. Please wait.
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
.
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
Similar presentations
