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Bone Tumors Clues and Cues Bone Tumors Clues and Cues William Herring, M.D. © 2002 In Slide Show mode, advance the slides by pressing the spacebar All Photos Retain the Copyright of their Authors

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Page 1: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Bone TumorsClues and CuesBone Tumors

Clues and Cues

William Herring, M.D. © 2002

In Slide Show mode, advance the slides by pressing the spacebarAll Photos Retain the Copyright of their Authors

Page 2: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Clues by Appearance

of Lesion

Page 3: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Patterns of Bone Destruction

Geographic

Moth-eaten

Permeative

Page 4: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Geographic Bone Destruction

Destructive lesion with sharply defined border

Implies a less-aggressive, more slow-growing, benign process

Narrow transition zone

Page 5: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Non-ossifying fibroma

Geographic

Moth-eaten

Permeative

Patterns of Bone DestructionPatterns of Bone Destruction

© R3, 2000

Page 6: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Geographic LesionsExamples

Non-ossifying fibroma

Chondromyxoid fibroma

Eosinophilic granuloma

Page 7: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Moth-eaten Appearance

Areas of destruction with ragged borders

Implies more rapid growthProbably a malignancy

Page 8: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Multiple Myeloma

Patterns of Bone DestructionPatterns of Bone Destruction

Geographic

Moth-eaten

Permeative

© R3, 2000

Page 9: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Moth-eaten AppearanceExamples

Myeloma

Metastases

Lymphoma

Ewing’s sarcoma

Page 10: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Permeative Pattern

Ill-defined lesion with multiple “worm-holes”

Spreads through marrow space

Wide transition zone

Implies an aggressive malignancy

Round-cell lesions

Page 11: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Leukemia

Patterns of Bone DestructionPatterns of Bone Destruction

Geographic

Moth-eaten

Permeative

Page 12: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Permeative PatternRound cell lesions

Lymphoma, leukemia

Ewing’s Sarcoma

Myeloma

Osteomyelitis

Neuroblastoma

Page 13: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Patterns of Destruction

Geographic Moth-eaten Permeative

Less malignant More malignant

Page 14: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Periosteal Reactions

BenignNoneSolid

More aggressive or malignantLamellated or onion-skinningSunburstCodman’s triangle

Page 15: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Non-ossifying fibroma

BenignNoneSolid

Aggressive/malignantOnion-skinningSunburstCodman’s triangle

Periosteal Reactions

© R3, 2000

Page 16: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chronic osteomyelitis

BenignNoneSolid

Aggressive/malignantOnion-skinningSunburstCodman’s triangle

Periosteal Reactions

© R3, 2000

Page 17: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

BenignNoneSolid

Aggressive/malignantOnion-skinningSunburstCodman’s triangle

Periosteal Reactions

Ewing’s sarcoma© Greenspan, 2000

Page 18: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteosarcoma

BenignNoneSolid

Aggressive/malignantOnion-skinningSunburstCodman’s triangle

Periosteal Reactions

© Greenspan, 2000

Page 19: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Ewing’s-Codman’striangle

BenignNoneSolid

Aggressive/malignantOnion-skinningSunburstCodman’s triangle

Periosteal Reactions

© R3, 2000

Page 20: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Periosteal Reactions

Solid Lamellated Sunburst Codman’s

Less malignant More malignant

Page 21: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Tumor Matrix

OsteoblasticFluffy, cotton-like or cloud-like densities

Osteosarcoma

CartilaginousComma-shaped, punctate, annular, popcorn-like

Enchondroma, chondrosarcoma, chondromyxoid fibroma

Page 22: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteoblastic

Cartilaginous

Tumor matrix

Osteosarcoma

© R3, 2000

Page 23: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteoblastic

Cartilaginous

Tumor matrix

Chondrosarcoma

© R3, 2000

Page 24: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Expansile Lesions of Bone

Multiple myeloma Brown tumor

Mets Enchondroma

Aneurysmal bone cyst Lymphoma

Fibrous dysplasia

Page 25: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Multiple Myeloma

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma

Page 26: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Renal Cell Carcinoma

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma

Page 27: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Aneurysmal Bone Cyst

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma

Page 28: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Fibrous Dysplasia

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma

Page 29: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Brown Tumor

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma © R3, 2000

Page 30: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Enchondroma

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma© R3, 2000

Page 31: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lymphoma

Expansile lesions

Multiple myeloma

Mets

Aneurysmal bone cyst

Fibrous dysplasia

Brown tumor

Enchondroma

Lymphoma © R3, 2000

Page 32: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Clues by Location

of Lesion

Page 33: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

In the Transverse Plane

CentralEnchondroma

EccentricGCT, osteosarcoma, chondromyxoid fibroma

CorticalNon-ossifying fibroma, osteoid osteoma

ParostealParosteal osteosarcoma, osteochondroma

Page 34: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Parosteal sarcoma

Osteochondroma

Osteosarcoma

In The Transverse Plane

© Greenspan, Lippincott, 2000

Page 35: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

In the Longitudinal Plane

EpiphysealGCT, chondroblastoma

MetaphysealOsteomyelitis, osteo- and chondrosarcoma

DiaphysealRound cell lesions, ABC, enchondroma

Page 36: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Tumor TypesCharacteristic Locations

Simple bone cystProximal humerus

ChondroblastomaEpiphyses

Giant Cell tumorEpiphyses

Page 37: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Simple bone cystProximal humerus

ChondroblastomaEpiphyses

Giant Cell tumorEpiphyses

Characteristic locations

© R3, 2000

Page 38: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chondroblastoma

Simple bone cystProximal humerus

ChondroblastomaEpiphyses

Giant Cell tumorEpiphyses

Characteristic locations

© R3, 2000

Page 39: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Giant Cell Tumor

Simple bone cystProximal humerus

ChondroblastomaEpiphyses

Giant Cell tumorEpiphyses

Characteristic locations

© R3, 2000

Page 40: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Tumor TypesCharacteristic Locations

AdamantinomaTibia

ChordomaSacrum, clivus

OsteoblastomaSpine, posterior

Page 41: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

AdamantinomaTibia

ChordomaSacrum, clivus

OsteoblastomaSpine, posterior

Characteristic locations

Adamantinoma© R3, 2000

Page 42: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

AdamantinomaTibia

ChordomaSacrum, clivus

OsteoblastomaSpine, posterior

Chordoma

Characteristic locations

© R3, 2000

Page 43: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteoblastoma

AdamantinomaTibia

ChordomaSacrum, clivus

OsteoblastomaSpine, posterior

Characteristic locationsCharacteristic locations

© R3, 2000

Page 44: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Tumor TypesCharacteristic Locations

Parosteal sarcomaDistal femur

Periosteal sarcomaTibia

Page 45: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Characteristic locations

Parosteal sarcomaDistal femur

Periosteal sarcomaTibia

Parosteal sarcoma

Page 46: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Characteristic locations

Parosteal sarcomaDistal femur

Periosteal sarcomaTibia

© R3, 2000

Page 47: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Characteristic Tumors

By Body Site

Page 48: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Pelvic Lesions

Chondrosarcoma

Solitary plasmacytoma

Chordoma

Page 49: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chondrosarcoma

Solitary plasmacytoma

Chordoma

Pelvic lesions

Page 50: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Chondrosarcoma

Solitary plasmacytoma

Chordoma

Pelvic lesions

Page 51: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chordoma

Chondrosarcoma

Solitary plasmacytoma

Chordoma

Pelvic lesions

© R3, 2000

Page 52: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Expansile Rib Lesions

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Page 53: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

Page 54: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

Thyroid Carcinoma

Page 55: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

© R3, 2000

Page 56: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

© R3, 2000

Page 57: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

© R3, 2000

Page 58: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Plasmacytoma

Metastases

Chondrosarcoma

Eosinophilic granuloma

Neurofibromatosis

Fibrous dysplasia

Expansile rib lesions

© R3, 2000

Page 59: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lesions of the Spine

OsteoblastomaExpansile, with punctate densities within

Chordoma

ABC

Metastatic disease

Page 60: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteoblastoma

Osteoblastoma

Chordoma

ABC

Metastatic disease

Spine lesions

© R3, 2000

Page 61: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chordoma

Osteoblastoma

Chordoma

ABC

Metastatic disease

Spine lesions

© R3, 2000

Page 62: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Aneurysmal bone cyst

Osteoblastoma

Chordoma

ABC

Metastatic disease

Spine lesions

Page 63: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Metastatic Breast Carcinoma

Osteoblastoma

Chordoma

ABC

Metastatic disease

Spine lesions

© R3, 2000

Page 64: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Clues by Density

Of Lesion

Page 65: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Sclerotic Cortical Lesions

Osteoid osteoma

Brodie’s abscess

Stress fracture

Page 66: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteoid Osteoma

Osteoid osteoma

Brodie’s abscess

Stress fracture

Sclerotic cortical lesions

Page 67: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Brodie’s abscess

Osteoid osteoma

Brodie’s abscess

Stress fracture

Sclerotic cortical lesions

© R3, 2000

Page 68: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Healing Stress Fracture

Osteoid osteoma

Brodie’s abscess

Stress fracture

Sclerotic cortical lesionsSclerotic cortical lesions

Page 69: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Sclerotic Cortical Lesions

Osteoid Osteoma Brodie’s abscess Healing Stress Fracture

Page 70: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lytic Lesions in Children

Eosinophilic granuloma

Neuroblastoma

Leukemia

Page 71: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Eosinophilic granuloma

Neuroblastoma

Leukemia

Lytic Lesions in Children

Eosinophilic granuloma© R3, 2000

Page 72: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Neuroblastoma

Eosinophilic granuloma

Neuroblastoma

Leukemia

Lytic Lesions in Children

© R3, 2000

Page 73: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Leukemia

Eosinophilic granuloma

Neuroblastoma

Leukemia

Lytic Lesions in Children

© R3, 2000

Page 74: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lytic Lesions in Adults

Metastatic lesionsLung

Renal

Thyroid

Multiple myeloma

Primary bone tumor

Page 75: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Met from Thyroid Carcinoma

Mets

Myeloma

Primary bone tumor

Lytic Lesions in Adults

Page 76: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Multiple myeloma

Mets

Myeloma

Primary bone tumor

Lytic Lesions in Adults

Page 77: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Chondrosarcoma

Mets

Myeloma

Primary bone tumor

Lytic Lesions in Adults

Page 78: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Blastic Lesions in Children

Medulloblastoma

Lymphoma

Page 79: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Medulloblastoma

Medulloblastoma

Lymphoma

Blastic Lesions in ChildrenBlastic Lesions in Children

© R3, 2000

Page 80: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lymphoma

Medulloblastoma

Lymphoma

Blastic Lesions in ChildrenBlastic Lesions in Children

Page 81: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Blastic Lesions in Adults

Metastatic diseaseBreast – female

Prostate – male

Lymphoma

Paget’s disease

Etcetera-mastocytosis, fluorosis

Page 82: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Prostate Mets

Mets

Lymphoma

Paget’s

Blastic Lesions in Adults

Page 83: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Breast Mets

Mets

Lymphoma

Paget’s

Blastic Lesions in Adults

Page 84: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lymphoma

Mets

Lymphoma

Paget’s

Blastic Lesions in AdultsBlastic Lesions in Adults

Page 85: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Paget’s of Spine

Mets

Lymphoma

Paget’s

Blastic Lesions in AdultsBlastic Lesions in Adults

Page 86: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Other Clues

Page 87: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Benign LesionsWithout Sclerotic Boarders

Giant Cell tumor

Brown tumor

Osteolytic phase of Paget’s Disease

Page 88: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Benign Lesions without Sclerotic Benign Lesions without Sclerotic BordersBorders

Giant cell tumor

Brown tumor

Osteolytic Paget’s

Giant Cell Tumor© R3, 2000

Page 89: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Brown Tumor

Benign Lesions without Sclerotic Benign Lesions without Sclerotic BordersBorders

Giant cell tumor

Brown tumor

Osteolytic Paget’s

© R3, 2000

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Osteolytic Paget’s

Benign Lesions without Sclerotic Benign Lesions without Sclerotic BordersBorders

Giant cell tumor

Brown tumor

Osteolytic Paget’s

© R3, 2000

Page 91: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Soft Tissue Extension

Usually implies malignancyMore likely to form discrete soft tissue mass

Benign conditions with soft tissue extension

OsteomyelitisUsually infiltration of fat

Page 92: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteosarcoma© R3, 2000

Page 93: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Multiple Lesions

More often benign

Malignancies with multiple lesionsMetastatic disease

Multiple myeloma

Lymphoma

Ewing’s sarcoma (rarely)

Osteosarcoma (rarely)

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Mets from Ca of Prostate

Multiple lesionsMultiple lesions

Metastatic

Multiple myeloma

Lymphoma

© R3, 2000

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Multiple Myeloma

Multiple lesionsMultiple lesions

Metastatic

Multiple myeloma

Lymphoma

© R3, 2000

Page 96: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Lymphoma

Multiple lesionsMultiple lesions

Metastatic

Multiple myeloma

Lymphoma

© R3, 2000

Page 97: Bone Tumors Clues and CuesGeographic Bone Destruction ODestructive lesion with sharply defined border OImplies a less-aggressive, more slow-growing, benign process ONarrow transition

Osteosarcomatosis

Multiple lesionsMultiple lesions

Metastatic

Multiple myeloma

Lymphoma

Osteosarcomatosis

© R3, 2000

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Benign vs. Malignant

© Greenspan, Lippincott, 2000

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The End


Case Report Simple Bone Cyst of Metacarpal: Rare Lesion ... · PDF fileAbstract Author’s Photo Gallery Case Report Simple Bone Cyst of Metacarpal: Rare Lesion with Unique Treatment

Gastric Pseudotumoral Lesion Caused by a Fish Bone ... · PDF fileGastric Pseudotumoral Lesion Caused by a Fish Bone Mimicking a Gastric Submucosal Tumor ... tend to manifest as an

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Bone Fracture and Lesion Assessment using Shape …...H. Martinke et al. / Bone Fracture and Lesion Assessment using Shape-Adaptive Unfolding 2. Related Work The technique proposed

Lesion Inmunitaria

Lesion Axonal Difusa, Contusion y Lesion Del Tallo Encefalico

Osteoma Benign lesion of bone Age: 30-60 Location: m/c frontal sinuses Margin: narrow Periosteal Rxn: none Soft Tissue Mass: abscent

Skin, Soft Tissue, & Bone Infections - Pirouette · PDF fileErysipelas • Erysipelas is a superficial cellulitis of skin and subcutaneous tissues with a sharply demarcated firm raised

JOINT LESIONS OF HYPERPARATHYROIDISM · hyperparathyroidism with an osteolytic lesion of the frontal bone. Both knees showed calcification in the suprapatellar pouch and deformed

Fractura Diafisaria Radiocubital, Lesion Monteggia, Lesion

LIFE IS FULL OF MAKE OR BREAK MOMENTS. · MENOPAUSE AND OSTEOPOROSIS During menopause, estrogen, a hormone that helps protect bone in women, sharply decreases. This results in bone

Non-ossifying fibroma (fibrous cortical defect). Lucent fibrous tissue lesion (benign) inside bone cortex. Mostly accidentally discovered by x- ray. Seen

Lesion isquiotibiales

HAVING OUR HEADS EXAMINED. Lesion Lesion INTRODUCTION

Good Anatomical Outcome of Orbital Plasmacytoma Following ...journalarticle.ukm.my/12696/1/19_aimy_et_al_pdf_71337.pdfmultiple lytic lesion corresponding to myeloma bone disease (Figure

Aneurysmal bone cyst of the zygomatic Arch causing limited ... · The Aneurysmal Bone Cyst (ABC) is an expansive osteolytic, radio-lucent, multilocular, eccentric lesion of unknown

HAVING OUR HEAD EXAMINED. Lesion Lesion INTRODUCTION

Lesion condral

DETECTION OF TEMPORAL BONE CHOLESTEATOMA BY …...on CT is temporal bone erosion. It has an osteolytic potential, which may be explained by the presence of collagenase in the lesion

Metastatic bone tumor Maher swaileh. Metastatic Disease Most common malignant lesion of bone. approximately 50 percent of tumors can spread or metastasize

Mature Bone in the Eye: A Case of Choroidal Osteoma2019/02/11  · Peripapillary and macular lesion, right eye. B. Paler lesion with temporal border of exudates, left eye. January

Aneurysmal Bone Cyst after Femoral Derotational Osteotomy ... · Aneurysmal Bone Cyst after Osteotomy 47 Traditional and standard treatment of ABCs include curettage of the lesion

BONE TUMORS By Dr. Ahmed Hosny. Clues by Appearance of Lesion Clues by Location of Lesion Clues by Density of Lesion Other Clues

Lesion tendinosas

Volume 1 Issue 2 ournal o urery · lesion was swollen, and it was identified as a bone tumor-like lesion or tumor. What’s more, eosinophilic granuloma has to be excluded, another

Lesion muscular

Location- and lesion-dependent estimation of background ... · Location- and lesion-dependent estimation of background tissue complexity for ... lesion shape or size ... lesion-dependent

Guided bone regeneration following surgical treatment …jos.dent.nihon-u.ac.jp/journal/56/1/P95-98.pdf · mixed lesion (radiolucent-radiopaque) of considerable ... The return following

Influence of dosimetry method on bone lesion absorbed dose

Bone Scanning - Springer › content › pdf › bfm:978-1-4471-1407-9 › 1.pdf · cussed. this may occur at some cost to the principal role of bone scanning. lesion detection. The

Multiple Myeloma: A Primary Care Approach...Multiple Myeloma Bone Imaging Types of bone disease associated with MM: Lytic lesion, Plasmacytoma, Osteopenia, Fracture incl. vertebral

Heterotopic mesenteric and omental ossification incidentally ......Heterotopic mesenteric and/or omental ossification is an uncommon bone-like lesion located inside the abdominal cavity

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Basic Interpretation of MRI and CT Scan in Brain Tumor Cases...Extraaxial lesion 2. Intraaxial lesion 3. Intra + Extra axial lesion 4. Fat content lesion 5. Blood content lesion 6

Lesion Medular