Bone Tumors and

Tumorlike Conditions

Andrea Evans Khosasih

406138139

Clues

by Age Predilection
Clues by Appearance of
Lesion
Clues by Location of Lesion
Clues by Density of Lesion
Other Clues

Clues by Age
Predilection

Important to remember

Small

zone of transition
Notice that in all three patients, the
growth plates have not yet closed.

 Wide

zone of transition

Clues by Appearance of
Lesion
Patterns

of Bone Destruction
Periosteal Reactions
Tumor Matrix

Clues by Appearance of
Lesion
Patterns

of Bone Destruction

Geographic
Moth-eaten
Permeative

Patterns of Bone
Destruction
Geographic

Non-ossifying fibroma

Geographic Bone
Destruction
Examples:
Non-ossifying fibroma
Chondromyxoid fibroma
Eosinophilic granuloma

Patterns of Bone
Destruction
Moth-eaten

Multiple Myeloma

Moth-eaten Bone
Destruction
Examples:
Myeloma
Metastases
Lymphoma
Ewings

sarcoma

Patterns of Bone
Destruction
Permeative

Leukemia

Permeative Bone
Destruction
Examples:
Lymphoma, leukemia
Ewings Sarcoma
Myeloma
Osteomyelitis
Neuroblastoma

Patterns of Bone
Destruction

Geographic

Less malignant

Moth-eaten

Permeative

More malignant

Periosteal Reactions
Benign

Solid
More

aggressive or malignant

Lamellated or onion peel

Sunburst
Codmans triangle

Periosteal Reactions

Benign
Solid

Chronic osteomyelitis

Periosteal Reactions

Aggressive/malignant
onion-peel

Ewing sarcoma

Periosteal Reactions

Aggressive/malignant
Sunburst

Osteo-sarcoma

Periosteal Reactions

Aggressive/malignant
Codmans triangle

Osteo-sarcoma

Periosteal Reactions

Solid

Sunburst

Less malignant

onion-peel

More malignant

Codmans
triangle

Important to remember

Tumor Matrix
Osteoblastic

Fluffy, cotton-like or cloud-like

densities
Osteosarcoma

Tumor Matrix
Osteoblas

tic

Tumor Matrix
Cartilaginous

Comma-shaped, punctate,
annular, popcorn-like
as Enchondroma,
chondrosarcoma, chondromyxoid
fibroma

Tumor Matrix
Cartilagino

us

Chondrosarcoma

Clues by Location of Lesion

In the Transverse Plane

In the Longitudinal Plane

Characteristic Locations by tumors

In the Transverse Plane

.

.
.

In the longitudinal
Plane
Epiphyseal

GCT, chondroblastoma

Metaphyseal
Osteomyelitis, osteo-and chondrosarcoma

Diaphyseal
Round cell lesions, ABC, enchondroma

Characteristic
Locations
Simple bone
cyst

Proximal humerus

Characteristic Locations
Chondroblasto

ma

Epiphyses

Characteristic Locations
Giant

tumor

Cell

Epiphyses

Characteristic Locations
Adamantinom

Tibia

Characteristic Locations
Chordoma
Sacrum, clivus

Characteristic Locations
Osteoblastom

Spine, posterior

Cortical Destruction

left: Chondromyxoid
fibroma
A benign, well-defined,
expansile lesion with
regular destruction of
cortical bone and a
peripheral layer of new
bone.
right: Giant cell tumor
A locally aggressive
lesion with cortical
destruction, expansion
and a thin, interrupted
peripheral layer of new
bone.
Notice the wide zone of
transition towards the
marrow cavity.

Benign vs. Malignant

Thank You