the radiology of malignant neoplasms
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The Radiology of Malignant Neoplasms. Juan F. Yepes, DDS, MD, MPH Spring 2009. The Radiology of Malignant Neoplasms. Malignant Tending to become progressively worse, and resulting in death. The Radiology of Malignant Neoplasms. Carcinoma Sarcoma. The Radiology of Malignant Neoplasms. - PowerPoint PPT PresentationTRANSCRIPT
TheRadiologyofMalignant Neoplasms
Juan F. Yepes, DDS, MD, MPH
Spring 2009
The Radiology of Malignant Neoplasms
Malignant
Tending to become progressively worse, and resulting in death
The Radiology of Malignant Neoplasms
CarcinomaSarcoma
The Radiology of Malignant Neoplasms
CarcinomaA malignant neoplasm made up of
epithelial cells.
The Radiology of Malignant Neoplasms
SarcomaA malignant neoplasm usually arising
from connective tissue cells, but some are of epithelial cell origin.
The Radiology of Malignant Neoplasms
1995 Estimated Cancer Deaths, United States
Percent Distribution of Sites by Sex
*Excluding basal and squamous cell skin cancers and in situ carcinomas except bladder
1995 Estimated New Cancer Cases, United States
Percent Distribution of Sites by Sex*
Melanoma of Skin 3%
Oral 3%
Lung 14%
Pancreas 2%
Stomach 2%
Colon & Rectum 10%
Prostate 36%
Urinary 8%
Leukemia & Lymphomas 7%
All Other 15%
3% Melanoma of Skin
2% Oral
32% Breast
13% Lung
2% Pancreas
12% Colon & Rectum
5% Ovary
8% Uterus
4% Urinary
4% Leukemia & Lymphoma
13% All Other
Melanoma of Skin 2%
Oral 2%
Lung 33%
Pancreas 5%
Stomach 3%
Colon & Rectum 9%
Prostate 14%
Urinary 5%
Leukemia & Lymphomas 6%
All Other 19%
1% Melanoma of Skin
1% Oral
18% Breast
24% Lung
5% Pancreas
11% Colon & Rectum
6% Ovary
4% Uterus
3% Urinary
8% Leukemia & Lymphoma
19% All Other
The Radiology of Malignant Neoplasms
Poorly defined Non-corticated Space occupying Non-resorption of teeth Destruction of anatomical structures
Poorly DefinedWell Defined
Corticated Non-corticated
Space Occupying vs. Non-Space Occupying
The Radiology of Malignant Neoplasms
Poorly defined Non-corticated Space occupying Non-resorption of teeth, usually Destruction of anatomical structures
The Radiology of Malignant Neoplasms
Poorly defined Non-corticated Space occupying Non-resorption of teeth, usually, but Destruction of anatomical structures
The Radiology of Malignant Neoplasms
ifand
only if
The Radiology of Malignant Neoplasms
Poorly defined Non-corticated Space occupying Non-directional resorption of teeth Destruction of anatomical structures
The Radiology of Malignant Neoplasms
Poorly defined Non-corticated Space occupying Non-resorption of teeth, usually Destruction of anatomical structures
Destruction of periosteum
Internal structure: trabeculae & calcification
“Unilocular” / “multilocular”
The Radiology of Malignant Neoplasms
Codman Triangles
Sunray Spicules
Sunburst Appearance
Destruction of periosteum
Internal structure: trabeculae & calcification
“Unilocular” / “multilocular”
The Radiology of Malignant Neoplasms
Cyst or
Benign Neoplasm Benign Neoplasm Malignant Neoplasm
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Carcinoma Ulceration Not usually a tumor mass*
The Radiology of Malignant Neoplasms
Carcinoma Primary carcinoma Secondary (metastatic) carcinoma
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Squamous Cell Carcinoma
Primary squamous cell carcinomaSecondary squamous cell carcinoma
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Teeth “standing in space”
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Carcinoma involving sinuses
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
CarcinomaSarcoma
The Radiology of Malignant Neoplasms
SarcomaA malignant neoplasm usually arising from connective tissue
cells, but some are of epithelial cell origin.
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Fibrosarcoma
•Ewing’s Sarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
• Mass (tumor) often found
• Bone production possible
• Mass (tumor) often found
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
Multiple Myeloma
Solitary Plasmacytoma
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
•Osteosarcoma
Rare in the jaws (distal femur, proximal tibia)
20s-30s (10s-70s)
Maxillofacial lesions in older age group
The Radiology of Malignant Neoplasms
Sarcoma
•Osteosarcoma
M > F
Mandible > Maxilla
Mandible younger than maxilla
The Radiology of Malignant Neoplasms
Sarcoma
•Osteosarcoma
Garrington sign (widened periodontal space)
Ragged, ill-defined radiolucent area
mixed radiopaque/radiolucent area
radiopaque area
The Radiology of Malignant Neoplasms
Sarcoma
•Osteosarcoma
Destruction of cortex
“Sun ray” spicule appearance
Codman triangles
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
Chondroma vs.Chondrosarcoma
It may be difficult, if not impossible, to tell chondromas from chondrosarcomas,
radiographically or histopathologically, in all cases.
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Chondrosarcoma
Mesenchymal Chondrosarcoma
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Moderately radiolucent
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Moderately radiolucent
Destructive, space occupying
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Moderately radiolucent
Destructive, space occupying
Flocculent calcification
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Moderately radiolucent
Destructive, space occupying
Flocculent calcification
Garrington sign (widened periodontal ligament)
The Radiology of Malignant Neoplasms
Sarcoma
•Chondrosarcoma
Anterior maxilla, posterior mandible
Maxilla: mandible 1:1
Mandible: symphysis, coronoid p., condyle
Maxilla: septal area
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Sarcoma
•Myeloma
•Osteosarcoma
•Chondrosarcoma
•Leukemia
The Radiology of Malignant Neoplasms
Sarcoma
•Leukemia
Monocytic
Myelocytic
Lymphocytic
The Radiology of Malignant Neoplasms
Sarcoma
•Leukemia
Acute
Chronic
The Radiology of Malignant Neoplasms
Sarcoma
•Leukemia
Loss of teeth
Loss of lamina dura and trabeculae
Simulation of periapical inflammation
The Radiology of Malignant Neoplasms
The Radiology of Malignant Neoplasms
Langerhans Cell Histiocytosis
Langerhans Cell Disease
Langerhans Histiocytosis
Histiocytosis X
Histiocytosis