Bone tumors

3,420 views

Published on

Bone tumors

Published in: Education, Health & Medicine
0 Comments
12 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
3,420
On SlideShare
0
From Embeds
0
Number of Embeds
2
Actions
Shares
0
Downloads
235
Comments
0
Likes
12
Embeds 0
No embeds

No notes for slide

Bone tumors

  1. 1. BONE TUMORSBONE TUMORS
  2. 2. • Clues by Appearance of Lesion • Clues by Location of Lesion • Clues by Density of Lesion • Other Clues
  3. 3. Clues by Appearance of Lesion • Patterns of Bone Destruction • Periosteal Reactions • Tumor Matrix • Expansile Lesions of Bone
  4. 4. Clues by Appearance of Lesion • Patterns of Bone Destruction – Geographic – Moth-eaten – Permeative
  5. 5. Geographic Bone Destruction • Destructive lesion with sharply defined border • Implies a less-aggressive, more slow- growing, benign process • Narrow transition zone
  6. 6. Patterns of Bone Destruction – Geographic – Moth-eaten – Permeative Non-ossifying fibroma
  7. 7. Geographic Bone Destruction Examples: • Non-ossifying fibroma • Chondromyxoid fibroma • Eosinophilic granuloma
  8. 8. Moth-eaten Bone Destruction • Areas of destruction with ragged borders • Implies more rapid growth • Probably a malignancy
  9. 9. Patterns of Bone Destruction – Geographic – Moth-eaten – Permeative Multiple Myeloma
  10. 10. Examples: • Myeloma • Metastases • Lymphoma • Ewing’s sarcoma Moth-eaten Bone Destruction
  11. 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. 12. Patterns of Bone Destruction – Geographic – Moth-eaten – Permeative Leukemia
  13. 13. Examples: • Lymphoma, leukemia • Ewing’s Sarcoma • Myeloma • Osteomyelitis • Neuroblastoma Permeative Bone Destruction
  14. 14. Patterns of Bone Destruction Geographic Moth-eaten Permeative Less malignant More malignant
  15. 15. Periosteal Reactions • Benign – None – Solid • More aggressive or malignant – Lamellated or onion peel – Sunburst – Codman’s triangle
  16. 16. Periosteal Reactions • Benign – None – Solid • Aggressive/malignant – onion-peel – Sunburst – Codman’s triangle Non-ossifying fibroma
  17. 17. Periosteal Reactions • Benign – None – Solid • Aggressive/malignant – onion-peel – Sunburst – Codman’s triangle Chronic osteomyelitis
  18. 18. Periosteal Reactions • Benign – None – Solid • Aggressive/malignant – onion-peel – Sunburst – Codman’s triangle Ewing sarcoma
  19. 19. Periosteal Reactions • Benign – None – Solid • Aggressive/malignant – onion-peel – Sunburst – Codman’s triangle Osteo-sarcoma
  20. 20. Periosteal Reactions • Benign – None – Solid • Aggressive/malignant – onion-peel – Sunburst – Codman’s triangle Osteo-sarcoma
  21. 21. Periosteal Reactions Solid onion-peelSunburst Codman’s triangle Less malignant More malignant
  22. 22. Tumor Matrix • Osteoblastic – Fluffy, cotton-like or cloud-like densities – Osteosarcoma • Cartilaginous – Comma-shaped, punctate, annular, popcorn-like – Enchondroma, chondrosarcoma, chondromyxoid fibroma
  23. 23. Tumor Matrix • Osteoblastic • Cartilaginous
  24. 24. • Osteoblastic – Fluffy, cotton-like or cloud-like densities as Osteosarcoma • Cartilaginous – Comma-shaped, punctate, annular, popcorn-like as Enchondroma, chondrosarcoma, chondromyxoid fibroma Tumor Matrix
  25. 25. • Osteoblastic • Cartilaginous Tumor Matrix Chondrosarcoma
  26. 26. • Multiple myeloma • Mets • Brown tumor • Enchondroma • Aneurysmal bone cyst • Fibrous dysplasia Expansile Lesions of Bone
  27. 27. Expansile Lesions of Bone Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia
  28. 28. Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Renal cell carcinoma
  29. 29. Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone
  30. 30. Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone
  31. 31. Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone
  32. 32. Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone
  33. 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. 34. In the Transverse Plane . . .
  35. 35. • Epiphyseal GCT, chondroblastoma • Metaphyseal Osteomyelitis, osteo-and chondrosarcoma • Diaphyseal Round cell lesions, ABC, enchondroma In the longitudinal Plane
  36. 36. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  37. 37. Characteristic Locations • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior
  38. 38. • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior Characteristic Locations
  39. 39. • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior Characteristic Locations
  40. 40. • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior Characteristic Locations
  41. 41. • Simple bone cyst Proximal humerus • Chondroblastoma Epiphyses • Giant Cell tumor Epiphyses • Adamantinoma Tibia • Chordoma Sacrum, clivus • Osteoblastoma Spine, posterior Characteristic Locations
  42. 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. 43. Sclerotic Cortical Lesions • Osteoid osteoma • Brodie’s abscess
  44. 44. • Osteoid osteoma • Brodie’s abscess Sclerotic Cortical Lesions
  45. 45. Lytic Lesions in Children • Eosinophilic granuloma • Leukemia
  46. 46. Lytic Lesions in Children • Eosinophilic granuloma • Leukemia
  47. 47. Lytic Lesions in Adults • Metastatic lesions – Lung – Renal – Thyroid • Multiple myeloma • Primary bone tumor Metastatic thyroid carcinoma
  48. 48. • Metastatic lesions – Lung – Renal – Thyroid • Multiple myeloma • Primary bone tumor Lytic Lesions in Adults
  49. 49. • Metastatic lesions – Lung – Renal – Thyroid • Multiple myeloma • Primary bone tumor Chondrosarcoma Lytic Lesions in Adults
  50. 50. • Lymphoma Blastic Lesions in Children
  51. 51. • Metastatic disease • Breast – female • Prostate – male • Lymphoma • Paget’s disease • Fluorosis Prostatic Ca. Blastic Lesions in Adults
  52. 52. • Metastatic disease • Breast –female • Prostate –male • Lymphoma • Paget’s disease • Fluorosis Blastic Lesions in Adults
  53. 53. • Metastatic disease • Breast –female • Prostate –male • Lymphoma • Paget’s disease • Fluorosis Blastic Lesions in Adults
  54. 54. • Metastatic disease • Breast –female • Prostate –male • Lymphoma • Paget’s disease • Fluorosis Blastic Lesions in Adults
  55. 55. Other Clues • Soft Tissue Extension • Benign vs. Malignant
  56. 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. 57. lymphoma Soft Tissue Extension
  58. 58. Benign vs. Malignant
  59. 59. Thank You

×