Malignant bone and soft tissue tumors

Histologic Types

• Mesenchymal: bone and cartilage: Enchondroma, Osteochondroma, Chondroblastoma, Osteosarcoma
• Round Cell: marrow infiltrative: Ewings sarcoma, Lymphoma, Langerhans cell histiocytosis

Plain Film Findings of Malignant Lesions

• Cortical Destruction - can be misleading as includes NOF, ABC, infection, EG.
• Perostitis - thick, dense and wavy are less agressive than lamelated (onion skinned) or sunbrust.
• Axis - vey poor determinator of benignity
• Zone of Transition - most reliable, narrow is good, wide and permeative are bad

Bone Tumors by Age

• <15 - Langerhans cell histiocytosis
• < 30 - Ewings sarcoma, Osteosarcoma, NOF, Solitary bone cyst, ABC, Fibrous dysplasia, Chondroblastoma
• 30-40 - Giant cell tumor, Parosteal sarcoma, Fibrosarcoma, Malignant fibrous histiocytoma, Lymphoma, Chondrosarcoma
• > 40 - Osseous metastasis, Myeloma

Lesion in the Posterior Elements of Spine - GO APE

• Giant cell tumor
• Osteoblastoma
• ABC
• Plasmacytoma
• EG

Links

Soft-Tissue Tumors and Tumorlike Lesions: A Systematic Imaging Approach