BONE TUMORS

BONE TUMORS. By Dr. Ahmed Hosny. Clues by Appearance of Lesion Clues by Location of Lesion Clues by Density of Lesion Other Clues. Clues by Appearance of Lesion. Patterns of Bone Destruction Periosteal Reactions Tumor Matrix Expansile Lesions of Bone. Clues by Appearance of Lesion.

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BONE TUMORS

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  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. PermeativeBone 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. PermeativeBone Destruction Examples: • Lymphoma, leukemia • Ewing’s Sarcoma • Myeloma • Osteomyelitis • Neuroblastoma
  14. Less malignant Moremalignant Patterns of Bone Destruction • Moth-eaten Permeative Geographic
  15. Periosteal Reactions • Benign • None • Solid • More aggressive or malignant • Lamellated or onion peel • Sunburst • Codman’s triangle
  16. Periosteal Reactions • Benign • None • Solid • Aggressive/malignant • onion-peel • Sunburst • Codman’s triangle Non-ossifying fibroma
  17. Periosteal Reactions • Benign • None • Solid • Aggressive/malignant • onion-peel • Sunburst • Codman’s triangle Chronic osteomyelitis
  18. Periosteal Reactions • Benign • None • Solid • Aggressive/malignant • onion-peel • Sunburst • Codman’s triangle Ewing sarcoma
  19. Periosteal Reactions • Benign • None • Solid • Aggressive/malignant • onion-peel • Sunburst • Codman’s triangle Osteo-sarcoma
  20. Periosteal Reactions • Benign • None • Solid • Aggressive/malignant • onion-peel • Sunburst • Codman’s triangle Osteo-sarcoma
  21. Less malignant More malignant Periosteal Reactions Solid • Sunburst • onion-peel • Codman’s • triangle
  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 • 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 Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  37. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  38. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  39. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  40. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  41. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • 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 • Osteoidosteoma • Brodie’s abscess
  44. Sclerotic Cortical Lesions • Osteoid osteoma • Brodie’sabscess
  45. Lytic Lesions in Children • Eosinophilicgranuloma • Leukemia
  46. Lytic Lesions in Children • Eosinophilic granuloma • Leukemia
  47. Lytic Lesions in Adults • Metastaticlesions • Lung • Renal • Thyroid • Multiple myeloma • Primary bone tumor Metastatic thyroid carcinoma
  48. Lytic Lesions in Adults • Metastatic lesions • Lung • Renal • Thyroid • Multiplemyeloma • Primary bone tumor
  49. Lytic Lesions in Adults • Metastatic lesions • Lung • Renal • Thyroid • Multiple myeloma • Primarybonetumor Chondrosarcoma
  50. Blastic Lesions in Children • Lymphoma Load More .

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