msk pseudo tumors imaging

1. PSEUDO
TUMORS
Daniel Vanel
Istituto Ortopedico Rizzoli. Bologna (Italia)
Hanoï November 2015

2. E Every lesion which is not tumoral, but can be interpreted
as a tumor from a clinical, radiographic and histological
point of view.
E These lesions mimick a malignant tumor:
- fast growth
- immature and/or poorly differentiated
- high mitotic rate
- occasional presence of necrosis
PSEUDO TUMORS

3. PSEUDO TUMORS
Trauma
Infection
Langerhans cell histiocytosis
Vascular
Myositis ossificans
Degenerative
Foreign body

4. Stress fracture
Uncomplete fracture of trabecular or cortical bone undergone to
continuous injury, athletic or occupational.
PSEUDO TUMORS Trauma

5. PSEUDO TUMORS Trauma
73 year old female

6. PSEUDO TUMORS Trauma
73 year old female

7. PSEUDO TUMORS Trauma
73 year old female
Stress fracture

8. PSEUDO TUMORS Trauma
Avulsion
Detachment of a bone fragment in the insertion of a tendon
Frequent surgical reconstruction

9. PSEUDO TUMORS Trauma
Periosteal desmoid
15 year old boy. Pain

10. PSEUDO TUMORS Trauma
Osteosarcoma

11. PSEUDO TUMORS Trauma
13 year old female

12. PSEUDO TUMORS Trauma
13 year old female

13. PSEUDO TUMORS Trauma
13 year old female

14. PSEUDO TUMORS Trauma
Avulsion
13 year old female

15. PSEUDO TUMORS Trauma
13 year old female
3 months later

16. PSEUDO TUMORS Trauma
E Use the 4th dimension (time)
E It is better to wait in front of a sarcoma
than to overtreat a benign lesion

17. PSEUDO TUMORS Infection
48 year old lady. Breast cancer. Thyroid cancer. Pain

18. PSEUDO TUMORS Infection
48 year old lady. Breast cancer. Thyroid cancer. Pain

19. PSEUDO TUMORS Infection
48 year old lady. Breast cancer. Thyroid cancer. Pain
Actinomycosis

20. PSEUDO TUMORS Infection
42 year old man. Pain
Hydatic
disease

21. PSEUDO TUMORS
9 year old boy. Pain
3 months later

22. PSEUDO TUMORS
9 year old boy. Pain
Langherans’ cell histiocytosis

23. PSEUDO TUMORS
10 year old boy. Pain and inflamatory reaction

24. PSEUDO TUMORS
10 year old boy. Pain and inflamatory reaction

25. PSEUDO TUMORS
10 year old boy. Pain and inflamatory reaction
1 month later Myositis ossificans
PSEUDO TUMORS Myositis ossificans

26. PSEUDO TUMORS
74 year old man. Known disease.
Growing mass of the knee. Referred for CT guided needle biopsy.

27. PSEUDO TUMORS
74 year old man. Known disease.
Growing mass of the knee. Referred for CT guided needle biopsy.

28. 74 year old man. Known disease.
Growing mass of the knee. Referred for CT guided needle biopsy.
Pseudo aneurysm
PSEUDO TUMORS

29. PSEUDO TUMORS
70 year old lady. Painful knee.
Geode

30. PSEUDO TUMORS
Foreign body

31. PSEUDO TUMORS CONCLUSION
E Multidisciplinary approach is mandatory to obtain a
correct diagnosis
Things are not always
what they look like !