Primary bone tumors and tumor-like lesions of the radius operated in a tertiary orthopedic oncology center

Background: Bone lesions are often histologically heterogenous. The advantage of tru-cut biopsies in this context is that they provide a safe and accurate biopsy technique that can be performed in less specialized centers. In this series we found combination of biopsy and cytology helpful in diagnosing bone lesions. However clinical picture and radiologic features are vital in arriving at a final diagnosis.Aims and Objective: 1) To assess the diagnostic accuracy of combined CT guided tru-cut biopsy and imprint cytology in the diagnosis of bone tumors and tumor like lesions. 2)To analyze the spectrum of different bone lesions.Materials and Methods: 108 consecutive cases of bone lesions for which CT guided tru-cut biopsy and imprint cytology were done between June 2010 and april 2012 were retrospectively studied. Both smears and biopsies were categorized into five groups.Correlation between biopsy and cytology were also evaluated.Results: Total number of cases were 108 of which 8 cases were inconclusive . In 100 cases a useful opinion could be given. There were 36 cases of primary bone tumors, 13 cases of plasma cell neoplasms, 42 metastatic tumors, 9 non neoplastic lesions and 8 inconclusive cases. Conclusion: Preliminary diagnosis of bone lesions before definitive therapy helps to avoid unnecessary surgical procedures. Tru cut biopsies supplemented by imprint cytology can provide definitive diagnosis in majority of cases.Asian Journal of Medical Sciences Vol.7(6) 2016 40-42

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Role of diffusion-weighted MRI in differentiating benign from malignant bone tumors

BJR|Open ◽

10.1259/bjro.20180048 ◽

2019 ◽

Vol 1 (1) ◽

pp. 20180048

Author(s):

Anuradha Rao ◽

Chandni Sharma ◽

Raghuram Parampalli

Keyword(s):

Bone Tumors ◽

Response To Treatment ◽

Diffusion Weighted Mri ◽

Benign Lesions ◽

Primary Bone Tumors ◽

Diffusion Weighted ◽

Adc Values ◽

Primary Bone ◽

Malignant Lesions ◽

Tumor Like Lesions

Objective: To evaluate the role of diffusion-weighted MRI in differentiating benign from malignant primary bone tumors. To know the sensitivity and specificity of diffusion weighted MRI and calculating apparent diffusion coefficient (ADC) cutoff in differentiating benign from malignant primary bone tumors. Methods and materials : This is a prospective observational study of 50 patients, who were clinically or radiologically suspected with primary bone tumor and referred to the Department of Radiodiagnosis, for radiography or for MRI. These patients underwent routine MRI sequences including diffusion-weighted MRI with b-values of 0, 500 and 1000, followed by pathological examination supplemented by immunohistochemistry (wherever necessary). Hematological malignancies, recently biopsied cases and recurrent cases were excluded from the study. Results: Out of 50 patients with suspected bone tumors, 15 were benign (and tumor like lesions) and 35 were malignant primary bone tumors. The most common age group involved for both benign and malignant primary bone tumors was 11–20 years (23 cases—46%). In our study, total number of affected males were 27 (54%) and total number of affected females were 23 (46%) with M:F ratio of 1.17:1. In this study 72% lesions had appendicular bone involvement and 28% had axial bone involvement. 94.3% of malignant lesions showed restriction on diffusion-weighted imaging (DWI) and in 80 % of benign lesions restriction was absent on DWI which was statistically significant. Mean ADC levels in malignant lesions was 1.092 ± 0.497 and in benign lesions was 1.62 ± 0.596 which was statistically significant. Chondrosarcoma had highest ADC and Ewing’s sarcoma had lowest ADC values in malignant lesions. Chondroblastoma had highest ADC and Osteomyelitis had lowest ADC values in benign lesions. ADC value of 1.31 had highest sensitivity and specificity to differentiate between benign and malignant lesions. Conclusion: DWI is helpful in differentiating malignant from benign bone tumors and tumor like lesions with diffusion restriction favoring malignancy. Inspite of some overlap, ADC values of benign and malignant bone tumors are different and measurement of ADC values improves the accuracy of the diagnosis of bone tumors and tumor like lesions. Calculation of ADC may also be used as baseline reference to assess response to treatment in future or for follow up. Advances in knowledge: DWI imaging (and ADC values) has been extensively used in neuroimaging. Extension of this application to musculoskeletal–oncologic imaging is not so well studied. Apart from differentiating benign from malignant lesions which is the main focus of this study, assessment of response to treatment by ADC values may be possible in near future.

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Imaging and differential diagnosis of primary bone tumors and tumor-like lesions of the spine

European Journal of Radiology ◽

10.1016/j.ejrad.2005.12.006 ◽

2006 ◽

Vol 58 (1) ◽

pp. 48-67 ◽

Cited By ~ 49

Author(s):

R. Erlemann

Keyword(s):

Differential Diagnosis ◽

Bone Tumors ◽

Primary Bone Tumors ◽

Primary Bone ◽

Tumor Like Lesions

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Transarticular Invasion of Primary Bone Tumors and Tumor-Like Lesions Near the Sacroiliac Joint: an MRI Study in 128 Patients

10.21203/rs.3.rs-257607/v1 ◽

2021 ◽

Author(s):

lei ding ◽

Dan Wei ◽

Danyang Xu ◽

Zhuo Wang ◽

Junqiang Yin ◽

...

Keyword(s):

Sacroiliac Joint ◽

Bone Tumors ◽

Primary Bone Tumors ◽

Significant Difference ◽

Malignant Group ◽

Primary Bone ◽

Group 3 ◽

Group 2 ◽

Tumor Like Lesions ◽

Type 3

Abstract Background： To investigate magnetic resonance imaging (MRI) manifestation of transarticular invasion of primary bone tumors and tumor-like lesions near the sacroiliac joint and to compare the transarticular invasion incidences and types of primary bone tumors and tumor-like lesions in different locations, of different pathological types, or of different pathological grades. Methods: A retrospective analysis of 128 patients . The diagnosis of the patients was confirmed by surgical findings and pathological examination. The primary tumor was in the ilium(87 patients) and sacrum(41 patients). Eighty men and 48 women with an average age of 32.5 years . Based on pathology grading systems, the tumors were divided into a high-grade malignant group (Group 1), low-grade malignant group (Group 2) and benign tumors/neoplasia group (Group 3). Transarticular invasion included 3 types: invasion across the ligament portion (Type 1), across articular cartilage (Type 2) and across periarticular tissue (Type 3). Results: Transarticular invasion of primary bone tumors and tumor-like lesions near the sacroiliac joint were diagnosed in 33 patients (25.8%). Transarticular invasion incidences were not significantly different between primary iliac and sacral tumors ,group 2 and group 3( P > 0.05). However, the transarticular invasion incidences were significantly different between group 2 or 3 and group 1 (P < 0.01). 33 patients with transarticular invasion, the invasion types included 31 type 1, 15 type 2 and 5 type 3 invasions. A significant difference was observed between different invasion types (P < 0.01). Conclusions: MRI is a highly sensitive method to diagnose transarticular invasion of primary bone tumors and tumor-like lesions near the sacroiliac joint. The transarticular invasion incidence is not significantly different between primary iliac and sacral lesions. Tumor invasion across the sacroiliac joint can be present in both primary bone tumors and tumor-like lesions but predominantly with high-grade malignant conventional osteosarcoma or Ewing's sarcoma. Transarticular invasion across the articular ligament portion is more common. No significant difference is evident between the 3 types of invasion in the groups with different pathological grades, suggesting that the transarticular invasion types are not related to benignity or malignancy or to the malignant degree of a tumor.

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A retrospective analysis of bone tumors and tumor like lesions: a hospital based study of 76 cases

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20174944 ◽

2017 ◽

Vol 5 (11) ◽

pp. 4915

Author(s):

Manoj Kumar Deka ◽

Anuradha Talukdar

Keyword(s):

Bone Tumors ◽

Primary Bone Tumor ◽

Primary Bone Tumors ◽

Skeletal Site ◽

Primary Bone ◽

To Come ◽

Histologic Types ◽

Conclusive Diagnosis ◽

Tumor Like Lesions ◽

Age Range

Background: Globally Bone tumors constitute 0.5% of the total World Cancer Incidence. In addition to benign and malignant bone tumors there are a number of nonneoplastic lesions that present in a manner similar to neoplastic conditions. Relevant demographic features such as age, sex and skeletal site are important to come to a conclusive diagnosis. The present study aims to show the prevalence and demography of bone tumors and tumor like lesions.Methods: A total of 76 cases of Bone Tumors and Tumor like Lesions were studied. They were reviewed and analyzed for age, gender, site of tumor and histologic types. Classification was done according to WHO histologic Classification of Bone Tumors.Results: There were 49 cases of primary bone tumors and tumor Like lesions with a median age of 22 years and 27 cases of metastatic bone tumors with a median age of 56 years. Males are more commonly affected. Osteosarcomas and Chondrosarcomas are the most common primary malignant Bone Tumors.Conclusions: Metastatic bone tumors constitute the highest number of bone tumors occurring at an older age group. Maximum numbers of bone tumors are found in the age range 11-20 years and all are primary bone tumor and tumor like lesions.

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The incidence and distribution of primary fibula tumors and tumor-like lesions: A 35-year experience

Journal of Orthopaedic Surgery ◽

10.1177/2309499018798180 ◽

2018 ◽

Vol 26 (3) ◽

pp. 230949901879818 ◽

Cited By ~ 1

Author(s):

Yavuz Arikan ◽

Abdulhamit Misir ◽

Devrim Ozer ◽

Turan Bilge Kizkapan ◽

Kadir Ilker Yildiz ◽

...

Keyword(s):

Bone Tumors ◽

Malignant Tumors ◽

Anatomic Site ◽

Distal Fibula ◽

Primary Bone Tumors ◽

Proximal Fibula ◽

Presenting Symptoms ◽

Common Location ◽

Primary Bone ◽

Tumor Like Lesions

Purpose: Primary bone tumors of the fibula are rare. There are only a few studies reporting the incidence, histologic, and anatomic distribution of primary fibula tumors. This study aimed to comprehensively report the incidence, presenting symptoms, and histologic tumor types with the anatomic and histologic distribution of primary bone tumors of the fibula. Methods: Between January 1983 and December 2017, 6457 primary bone tumors and tumor-like lesions were diagnosed and treated in our musculoskeletal oncology surgery clinic. Of these, 264 (4.08%) were primary bone tumors and tumor-like lesions of the fibula. We retrospectively reviewed patients’ records, histopathology records, and radiologic images regarding age, gender, anatomic localization, histopathologic diagnosis, and treatment methods. Results: There were 209 (79.2%) benign and 55 (20.8%) malignant lesions. The most common benign and malignant tumors were osteochondroma (51 of 209; 24.4%) and chondrosarcoma (16 of 55; 29.1%). The proximal fibula was the most common location for both benign and malignant tumors (141 of 209; 67.5% and 45 of 55; 81.8%, respectively), followed by the distal fibula (52 of 209; 24.9% and 8 of 55; 14.5%, respectively) and the diaphysis (17 of 209; 8.14% and 2 of 55; 3.64%, respectively). Conclusion: The incidence of primary bone tumors is higher than that reported in previous studies. Benign lesions constitute the majority of cases. One-fifth of all cases are malignant. The most common anatomic site involving the primary fibula tumors is the proximal fibula. Level of evidence: III.

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Scintigraphy with 99m Tc-Phosphonate and 67Gallium in Patients Suspected of Primary Bone Tumors

Nuklearmedizin ◽

10.1055/s-0037-1620567 ◽

1982 ◽

Vol 21 (04) ◽

pp. 136-139 ◽

Cited By ~ 2

Author(s):

C.-J. Edeling

Keyword(s):

Soft Tissue ◽

Bone Scintigraphy ◽

Primary Tumor ◽

Bone Tumors ◽

Whole Body ◽

Skeletal Metastases ◽

Malignant Bone Tumors ◽

67Ga Scintigraphy ◽

Primary Bone Tumors ◽

Primary Bone

Whole-body scintigraphy with both 99mTc-phosphonate and 67Ga was performed on 92 patients suspected of primary bone tumors. In 46 patients with primary malignant bone tumors, scintigraphy with 99mTc-phosphonate disclosed the primary tumor in 44 cases and skeletal metastases in 11, and 67Ga scintigraphy detected the primary tumor in 43 cases, skeletal metastases in 6 cases and soft-tissue metastases in 8 cases. In 25 patients with secondary malignant bone tumors, bone scintigraphy visualized a single lesion in 10 cases and several lesions in 15 cases, and 67Ga scintigraphy detected the primary tumor in 17 cases, skeletal metastases in 17 cases and soft-tissue metastases in 9 cases. In 21 patients with benign bone disease positive uptake of 99mTc-phosphonate was recognized in 19 cases and uptake of 67Ga in 17 cases. It is concluded that bone scintigraphy should be used in patients suspected of primary bone tumors. If malignancy is suspected, 67Ga scintigraphy should be performed in addition.

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