Diferencia entre revisiones de «Bone tumors and their mimics»
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== | ==Benign<ref>Czerniak, Bogdan. “Benign Osteoblastic Tumors.” Dorfman and Czerniak's bone tumors. Elsevier Health Sciences, 2015, pp. 144 – 199.</ref>== | ||
*[[Giant cell tumor]] | *[[Giant cell tumor]] | ||
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| Osteoid Osteoma||Adolescent male with bone pain over femur; pain worse at night and unrelated to activity||Radiolucent nidus with sclerotic edges most often seen in proximal femur||Nidus produces prostaglandins, Aspirin/NSAIDs can relieve pain; most soft resolve | | Osteoid Osteoma||Adolescent male with bone pain over femur; pain worse at night and unrelated to activity||Radiolucent nidus with sclerotic edges most often seen in proximal femur||Nidus produces prostaglandins, Aspirin/NSAIDs can relieve pain; most soft resolve | ||
|} | |||
==Malignant== | |||
==Differential Diagnosis<ref>Niederhuber, John E., et al. “Sarcomas.” Abeloff's Clinical Oncology E-Book. Elsevier Health Sciences, 2019, pp. 1604 – 1654.e8.</ref>== | |||
*[[Multiple myeloma]] | |||
*[[Osteosarcoma]] | |||
*[[Chondrosarcoma]] | |||
*[[Ewing sarcoma]] | |||
{| {{table}} | |||
| align="center" style="background:#f0f0f0;"|'''Name''' | |||
| align="center" style="background:#f0f0f0;"|'''Presentation''' | |||
| align="center" style="background:#f0f0f0;"|'''Radiograph Findings''' | |||
| align="center" style="background:#f0f0f0;"|'''Clinical Importance''' | |||
|- | |||
| Adamantinoma||Bone pain over anterior tibia in adolescent or young adult||Soap bubble osteolytic appearance on plain radiograph||Metastasis to lungs; may need amputation | |||
|- | |||
| Chordoma||Constant pain if in sacrum; neurological deficits if at base of skull, most commonly in cranial nerves to the eye ||Plain radiograph will show a destructive bone lesion often with an associated soft tissue mass||Slow growing but locally aggressive; metastasis is uncommon, local recurrence is much more likely | |||
|- | |||
| Fibrosarcoma and Undifferentiated pleomorphic sarcoma||Similar to osteosarcoma except malignant fibroblasts but less common||Most common in distal femur and proximal tibia||Similar outcome to osteosarcoma | |||
|- | |||
| Primary bone lymphoma||Adult > 40 years of age with bone pain or pathologic fracture||Bone destruction; soft tissue mass||5 year survival is greater than 50% with radiation and chemotherapy | |||
|} | |} | ||
==See Also== | ==See Also== | ||
*[[Benign bone tumors]] | |||
*[[Malignant bone tumors]] | *[[Malignant bone tumors]] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
Revisión del 04:32 11 dic 2019
Benign[1]
| Name | Presentation | Radiograph Findings/Location | Clinical Importance |
| Chondroblastoma | Bone or joint pain in adolescent | Epiphysis of long bones, may cross growth plate | Growth disturbance, arthritis |
| Enchondroma | Soft tissue mass in hands or feet of adolescent; seen in Ollier Disease or Mafucci Syndrome | Metaphysis of long bones in hands or feet; oval lesion with sclerotic edges and central lucency | Malignant transformation to chondrosarcoma if multiple lesions present |
| Langerhans cell histiocytosis of bone | Painful swelling of skull in children, typically frontal bone, or long bones | Lytic, punched out lesion | Lesion of skull can be associated with diabetes insipidus or other CNS disease; pathological fracture of long bone |
| Osteoblastoma | Adolescent male with chronic pain in spine, most often seen in posterior column | Similar to osteoid osteoma but typically > 2cm | May appear like osteoid osteoma on plain film but DOES NOT respond to Aspirin/NSAIDs |
| Osteochondroma | Adolescent male with painless mass over distal femur | Osseous spur that arises from cortex pointing away from joint | Observation without treatment; small risk of transformation to chondrosarcoma |
| Osteoid Osteoma | Adolescent male with bone pain over femur; pain worse at night and unrelated to activity | Radiolucent nidus with sclerotic edges most often seen in proximal femur | Nidus produces prostaglandins, Aspirin/NSAIDs can relieve pain; most soft resolve |
Malignant
Differential Diagnosis[2]
| Name | Presentation | Radiograph Findings | Clinical Importance |
| Adamantinoma | Bone pain over anterior tibia in adolescent or young adult | Soap bubble osteolytic appearance on plain radiograph | Metastasis to lungs; may need amputation |
| Chordoma | Constant pain if in sacrum; neurological deficits if at base of skull, most commonly in cranial nerves to the eye | Plain radiograph will show a destructive bone lesion often with an associated soft tissue mass | Slow growing but locally aggressive; metastasis is uncommon, local recurrence is much more likely |
| Fibrosarcoma and Undifferentiated pleomorphic sarcoma | Similar to osteosarcoma except malignant fibroblasts but less common | Most common in distal femur and proximal tibia | Similar outcome to osteosarcoma |
| Primary bone lymphoma | Adult > 40 years of age with bone pain or pathologic fracture | Bone destruction; soft tissue mass | 5 year survival is greater than 50% with radiation and chemotherapy |