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Radiology
Malignant Bone and Soft Tissue Tumors
Built from Fundamentals of Diagnostic Radiology
What’s inside
3 sections · 67 slides
Radiographic Findings
Four plain-film signs separate benign from aggressive bone lesions
- Four plain-film criteria
- Only the zone of transition is reliable
- Cortical destruction can mislead
- Cortical replacement mimicking destruction
- Aneurysmal bone cyst thinning the cortex
- Periostitis: aggressive vs benign
- Periostitis alone can mislead
- Benign and aggressive periostitis
- Orientation of the lesion is unreliable
- Zone of transition: wide vs narrow
- Permeative lesions have a wide zone
- Narrow zone of transition
- Wide zone of transition
- Age narrows the differential
- Age of patients with malignant bone tumors
- MR shows extent, not just character
- MR appearance: malignant vs benign
- MR signal rules and exceptions
- Lipoma on MR
- Hemangioma on MR
- When gadolinium is needed
- Solid mass or fluid: let contrast decide
- Fat suppression can fake enhancement
- Schwannoma on MR
- Effect of fat suppression
Malignant Bone Tumors
The short list of primary bone malignancies, grouped by age
- Osteosarcoma
- Osteosarcoma: mixed lytic and sclerotic
- Osteosarcoma: densely sclerotic
- Parosteal osteosarcoma
- Mimics of parosteal osteosarcoma
- Parosteal osteosarcoma
- Parosteal osteosarcoma with bony involvement
- Ewing sarcoma
- Permeative lesion in a child
- Ewing sarcoma with sunburst periostitis
- Chondrosarcoma
- Chondrosarcoma: popcorn calcification
- Chondrosarcoma: amorphous calcification
- Malignant giant cell tumor
- Malignant fibrous histiocytoma (MFH)
- Malignant fibrous histiocytoma: permeative lysis
- Malignant fibrous histiocytoma: iliac wing
- Desmoid tumor of bone
- Desmoid tumor of bone
- Primary lymphoma of bone
- Primary lymphoma of bone
- Metastatic disease
- Blastic metastases from prostate
- Lytic metastasis from renal cell carcinoma
- Myeloma
- Myeloma: permeative femur
- Myeloma: skull lytic lesions
Soft Tissue Tumors
Masses that need MR signal and contrast to sort from fluid
- Soft tissue masses: few reliable rules
- Synovial sarcoma
- Synovial osteochondromatosis
- Synovial osteochondromatosis
- Pigmented villonodular synovitis (PVNS)
- Pigmented villonodular synovitis: erosions
- Pigmented villonodular synovitis: hemosiderin on MR
- Hemangioma in soft tissue
- Soft tissue hemangioma with cortical holes
- Atypical synovial cysts
- Atypical synovial cyst on CT and MR
- Atypical synovial cyst: fluid-like signal
- Key takeaways
- Suggested Readings
- Brant and Helms' Fundamentals of Diagnostic Radiology