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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

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