Thursday, 25 June 2015

Bone tumow

1. Osteosarcoma: 

Age: 10-20 yrs (except when its secondary e.g. in Paget's disease in old age)MetaphysealSunray periosteal reactionnote: sunburst calcification on abdominal X-ray is seen in Pancreatic serous cystadenomaCodman triangle note: codman tumor is chondroblastomaRadioresistant

2. Ewing's sarcoma

Age: 10-20 yrslaminated periosteal reaction: onion skinlocation: diaphysealRadiosensitive

3. Giant cell tumor (GCT) = osteoclastoma

Epiphysealother epiphyseal lesions - Chondroblastoma, GeodeSoap bubble appearanceMetaepiphyseal: Seen after fusion of epiphysis (age 20-50 yrs)

4. Vertebral hemangioma

X-ray and Sagittal CT: Corduroy cloth appearanceAxial CT: Polka dot appearance

5. Adamantinoma

Mandible (Ameloblastoma): 3rd-5th decadeTibial diaphysis: 10-20 yrs, typically anterior cortexPituitary (Both pituitary stalk and enamel arise from oral epithelium)

6. Above 60 years, multiple lytic lesions

Multiple myeloma Normal alkaline phosphatase, cold on bone scanpunched out lytic lesionsMetastasesIncreased alkaline phosphatase, hot on bone scan i.e. high uptake

7. Metastases

Sclerotic/osteoblasticCommonly from: Prostate and Breast (can have mixed)Other: Stomach, CarcinoidLytic and expansileCommonly from Kidney and Thyroid

8. Hyperparathyroidism

subperiosteal bone resorptionradial aspect of proximal and middle phalanges of the 2nd and 3rd fingerslamina dura: floating teethSalt and pepper skull = pepper pot skullBrown tumorerosion of lateral end of clavicalrugger jersey spine (secondary hyperparathyroidism due to renal osteodystrophy)note: picture frame vertebra is seen in Paget's disease of bone (also Cotton wool skull in Paget's)note: sandwich vertebra is seen in osteopetrosis

9. Eosinophilic granuloma

childrenbeveled edgesvertebral planafloating teeth (also seen with hyperparathyroidism)

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