← All decks

Radiology

Malignant Bone and Soft Tissue Tumors

Built from Fundamentals of Diagnostic Radiology

What’s inside

3 sections · 67 slides

  1. 01

    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

    25 slides

  2. 02

    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

    27 slides

  3. 03

    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

    15 slides