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Sample records for chondroblastoma

  1. Vertebral chondroblastoma

    International Nuclear Information System (INIS)

    To determine the age distribution, gender, incidence, and imaging findings of vertebral chondroblastoma, and to compare our series with findings from case reports in the world literature.Design and patients Case records and imaging findings of nine histologically documented vertebral chondroblastomas were retrospectively reviewed for patient age, gender, vertebral column location and level, morphology, matrix, edema, soft tissue mass, spinal canal invasion, and metastases. Our findings were compared with a total of nine patients identified from previous publications in the world literature. The histologic findings in our cases was re-reviewed for diagnosis and specifically for features of calcification and secondary aneurysmal bone cyst (ABC). Clinical follow-up was requested from referring institutions. Nine of 856 chondroblastomas arose in vertebrae (incidence 1.4%; thoracic 5, lumbar 1, cervical 2, sacral 1). There were six males and three females ranging in age from 5 to 41 years (mean 28 years). Satisfactory imaging from seven patients revealed the tumor to arise from the posterior elements in four and the body in three. All tumors were expansive, six of seven were aggressive, and the spinal canal was significantly narrowed by bone or soft tissue mass in six. In one patient canal invasion was minimal. Calcification was pronounced in two and subtle in four. The sole nonaggressive-appearing tumor was heavily mineralized. Bony edema and secondary ABC were not seen on MR imaging. None of the cases had microscopic features of significant secondary ABC. Calcification, and specifically ''chicken wire'' calcification, was identified in two patients. Pulmonary metastases occurred in none. Vertebral chondroblastoma is a rare neoplasm that presents later in life than its appendicular counterpart. On imaging it is aggressive in appearance with bone destruction, soft tissue mass, and spinal canal invasion. The lesions contain variable amounts of mineral. Secondary

  2. Chondroblastoma of the Navicular Bone

    International Nuclear Information System (INIS)

    This is a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed as chondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention to chondroblastoma

  3. Imaging findings of tarsal chondroblastoma

    International Nuclear Information System (INIS)

    Objective: To analysis the imaging features of the chondroblastoma in the tarsal bone. Methods: The locations of 134 cases of pathologically confirmed chondroblastoma were retrospectively analyzed. Eleven of them were in tarsal bones and their X-ray and CT findings were analyzed. Results: Of the 11 cases of tarsal chondroblastoma, 6 were in talus, 3 were in calcaneus and 2 cases were in navicular bones. They were examined by the X-ray and 5 cases had additional CT scans. The common locations were the posterior portion of the talus and calcaneus. The X-ray findings included expansive destruction (10/11), mild osteosclerosis (11/11), bone ridge (9/11), articular facet destruction (7/11) and spot or patching calcification (6/11). The imaging findings of CT included articular facets destruction (5/5), bone ridge (5/5) and spot or patching calcification (2/5). Conclusion: The talus and the calcaneus are the frequently involved location of tarsal chondroblastoma. Its X-ray and CT findings are characteristic but not exclusive. (authors)

  4. Chondroblastoma of the sphenoid bone

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    Patrocíni, Tomas Gomes

    2008-12-01

    Full Text Available Introduction: Chondroblastoma is an uncommon cartilaginous benign neoplasm, highly destructive, which specifically appears in the epiphysis of long bones in young patients. Its occurrence is extremely rare in the cranial base, normally occurring in the temporal bone. Objective: To describe a rare case in a patient presenting with a sphenoid bone chondroblastoma that invaded the middle cranial cavity, submitted to a successful surgical resection, without recurrence after 2 years. Case Report: W.J.S, 37 years old, male, forwarded to the otorhinolaryngology service with persistent and strong otalgia for 3 months. He had normal otoscopy and without visible tumorations. The computerized tomography confirmed tumor mass in the left infra-temporal cavity, invading the middle cranial cavity. The biopsy suggested giant cells tumor. After wide resection by frontal approach via orbitozygomatic osteotomy. During the surgery, we confirmed tomographic statements and didn't find temporal bone involvement. The histopathological exam confirmed chondroblastoma. After 18 months after the surgery, he doesn't present with complaints, without motor, sensitive deficits or of cranial nerves and without recurrence tomographic signals. Conclusion: The importance of differential diagnosis of chondroblastoma is remarkable in the cranial base lesions and its therapeutic approach, whose objective must always be the major possible resection with the maximum function conservation.

  5. Chondroblastoma of the Navicular Bone

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    Li, Xiao Na; Peng, Zhi Gang; Zhao, Jing Pin; Zhang, Ze Kun

    2014-01-01

    This is a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed as chondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention to chondrobl...

  6. Chondroblastoma of the hands and feet

    International Nuclear Information System (INIS)

    To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm2. Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

  7. Chondroblastoma of the hands and feet

    Energy Technology Data Exchange (ETDEWEB)

    Davila, Jesse A.; Amrami, Kimberly K.; Sundaram, Murali; Adkins, Mark C. [Mayo Clinic, Department of Radiology, Rochester (United States); Unni, Krishnan K. [Mayo Clinic, Department of Surgical Pathology, Rochester (United States)

    2004-10-01

    To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm{sup 2}. Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

  8. Peculiar chondroblastoma involving multiple tarsal bones

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    Fukunaga, Masaharu [Jikei University School of Medicine, Department of Pathology, Tokyo (Japan); the Jikei University Daisan Hospital, Department of Pathology, Tokyo (Japan); Asanuma, Kazuo [Jikei University School of Medicine, Department of Orthopedic Surgery, Tokyo (Japan); Irie, Takeo [Jikei University School of Medicine, Department of Radiology, Tokyo (Japan)

    2010-07-15

    A case of peculiar chondroblastoma involving multiple tarsal bones in a 49-year-old woman is described. The patient presented with pain and swelling of the right foot. Radiographs revealed a lytic expansile lesion of medial, intermediate, and lateral cuneiform bones, navicular, cuboid, and tarsal bones of the right foot, indicating a malignant tumor. Biopsies demonstrated a diffuse proliferation of round cells with eccentric and indented nuclei with longitudinal grooves and eosinophilic cytoplasm. Atypia was prominent, but mitotic figures were rare. The stroma was chondroid with focal chicken-wire calcification. On electron microscopy, the tumor exhibited chondroblastic features. The patient is alive with the tumor 7 years after radiotherapy. The tumor is considered a chondroblastoma with low malignant potential. (orig.)

  9. Peculiar chondroblastoma involving multiple tarsal bones

    International Nuclear Information System (INIS)

    A case of peculiar chondroblastoma involving multiple tarsal bones in a 49-year-old woman is described. The patient presented with pain and swelling of the right foot. Radiographs revealed a lytic expansile lesion of medial, intermediate, and lateral cuneiform bones, navicular, cuboid, and tarsal bones of the right foot, indicating a malignant tumor. Biopsies demonstrated a diffuse proliferation of round cells with eccentric and indented nuclei with longitudinal grooves and eosinophilic cytoplasm. Atypia was prominent, but mitotic figures were rare. The stroma was chondroid with focal chicken-wire calcification. On electron microscopy, the tumor exhibited chondroblastic features. The patient is alive with the tumor 7 years after radiotherapy. The tumor is considered a chondroblastoma with low malignant potential. (orig.)

  10. Case report 449: Chondroblastoma involving C5 and C6

    International Nuclear Information System (INIS)

    A case of chondroblastoma of the cervical spine is presented in a sixteen year old male. Both the axial location and the presence of an associated soft tissue mass make this an unusual case. Treatment is briefly considered. (orig.)

  11. Case report 449: Chondroblastoma involving C5 and C6

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    Howe, J.W.; Yochum, T.R.; Sladich, M.A.; Baumgard, S.

    1988-01-01

    A case of chondroblastoma of the cervical spine is presented in a sixteen year old male. Both the axial location and the presence of an associated soft tissue mass make this an unusual case. Treatment is briefly considered. (orig.)

  12. Diaphyseal chondroblastoma in a long bone: first report

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    Azorin, D.; Gonzalez-Mediero, I.; Colmenero, I.; Prada, I. de [Hospital Infantil Universitario Nino Jesus, Service of Anatomic Pathology, Madrid (Spain); Lopez-Barea, F. [Hospital Universitario La Paz, Department of Anatomic Pathology, Madrid (Spain)

    2006-01-01

    Chondroblastoma is a rare benign bone tumor typically located in the epiphysis. We describe the first case of chondroblastoma arising in the diaphysis of a long bone. The patient was a 13-year-old girl who presented with pain over her right thigh. Radiographs showed a lytic lesion in the diaphysis of her right femur. A core biopsy and a subsequent surgical resection were performed. (orig.)

  13. Secondary aneurysmal bone cyst following chondroblastoma of the patella

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    Tomoyuki Kato

    2013-09-01

    Full Text Available Aneurysmal bone cyst (ABC is a rare benign cystic lesion of the bone that composes 1-2% of the entire bone tumors. Some are idiopathic, and some occur secondary to other tumors such as giant cell tumor and chondroblastoma. In this article, we report the clinical, radiographic, and histological findings of a secondary ABC following chondroblastoma of the patella with a review of the literature.

  14. Chondroblastoma associated with aneurysmal cyst of the navicular bone: a case report

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    Fang, Zhenhua; Chen, Ming

    2013-01-01

    Chondroblastoma is a rare tumor. It is usually benign; however, it can have an aggressive course before or after operative treatment, even resulting in pulmonary metastases. The foot is a rare location for chondroblastoma, and to our knowledge, chondroblastoma occurring in the navicular bone has not been reported previously in the English literature. We describe a case of navicular chondroblastoma case associated with an aneurysmal bone cyst. Treatment consisted of aggressive curettage, pheno...

  15. Chondroblastoma patella presenting as a pathological fracture

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    Gudi Narayan

    2008-01-01

    Full Text Available A 24-year-old male presented with an inability to walk after a trivial fall. He had pain and mild swelling anterior to the right knee for the past one year. X-ray showed a transverse fracture of patella with a lytic lesion occupying most of the two halves of the patella. Fine needle aspiration cytology (FNAC of the lytic lesion revealed a few osteoclastic giant cells and occasional osteoblasts against a hemorrhagic background. Patellectomy was performed. Histology revealed trabecular bone admixed with proliferating chondroid tissue at places admixed with myxoid and fibrous tissue with focal areas of calcification suggestive of chondroblastoma. Focal areas showed osteoclastic giant cells with areas of hemorrhage. The purpose is to present a rare tumor occurring at an unusual site which presented as pathological fracture.

  16. Temporal bone chondroblastoma totally invisible on MRI.

    Science.gov (United States)

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi

    2016-08-01

    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach. PMID:26743837

  17. Imaging and therapy of a chondroblastoma

    International Nuclear Information System (INIS)

    The chondroblastoma is a rare lytic osseous lesion, which is typically to be found in the epiphyses of the long tubular bones. We present a case report with the differential diagnostic imaging and the surgical therapy of a chondroblastoma of the proximal tibial epiphysis. A 16-year-old male presented in the traumatological accident and emergency centre with knee pain of unclear origin that had been increasing for several months. He had no memory of any acute trauma. For further clarification, a conventional radiography in two planes, a thin-layer CT, a multiplanar MRI before and after Gd-DTPA, and a bone scan were performed. The conventional radiological diagnostics show a smoothly circumscribed, osteolytic, eccentric lesion with marginal sclerosis, which does not exceed the epiphyseal seam of the proximal tibia. The thin-layer CT reveals an eccentric osteolysis, with a typical, narrow sclerotic seam and central calcifications. In the high-resolution MRI, the T2-weighted sequences show a locally limited, epiphyseal, lubulated lesion with a heterogeneous, in part raised signal. A further signal increase can be seen in the T1-weighted sequences after administration of Gd-DTPA. Perifocally, there is an epiphyseal edema and discrete (intraarticular fluid collection) fluid in the inner knee. In the skeletal scintigraphy, there is a strong focal and diffuse increased activity from the proximal, lateral tibial epiphysis. After the diagnosis had been rendered, curettage of the defect was performed and then, after histological confirmation of the diagnosis, completing spongiosaplasty was conducted. Taking into account the localisation and the patient's age, a virtually certain diagnosis can already be rendered using conventional imaging. A supplementary MRI or CT can be helpful for final clarification, while 3-phase skeletal scintigraphy is superfluous. The therapy of choice is curettage and subsequent filling of the defect with autologous spongiosa. (orig.)

  18. Condroblastoma de escafoides carpiano Chondroblastoma of the carpal scaphoids

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    F.J. Repáraz

    2008-12-01

    Full Text Available El condroblastoma es un tumor benigno de origen cartilaginoso que representa menos del 1% de todos los tumores óseos primarios. Se localiza típicamente en la epífisis de los huesos largos. Un 10% de los condroblastomas afectan a huesos del pie y de la mano. El asiento de esta lesión en el carpo es extraordinariamente raro. Se presenta un caso de condroblastoma del escafoides del carpo que fue tratado mediante curetaje de la lesión y relleno con injerto óseo autólogo de cresta iliaca.A chondroblastoma is a benign tumour of cartilaginous origin which represents less than 1% of all primary osseous tumours. It is typically localised in the epiphysis of the long bones. Some 10% of chondroblastomas affect the bones of the foot and the hand. It is extremely rare for the seat of this lesion to be in the carpal bones. We present a case of chondroblastoma of the carpal scaphoids that was treated through curretage of the lesion and filling with autologous osseous graft from the iliac crest.

  19. MR findings of chondroblastoma with emphasis on enhancement pattern

    International Nuclear Information System (INIS)

    To analyze the MR findings of chondroblastoma and peritumoral bone marrow, focussing on the enhancement pattern. Enhanced MR images obtained from 23 patients with pathologically proven chondroblastoma were retrospectively reviewed by three radiologists. The enhancement pattern was classified as one of three types: homogeneous, heterogeneous, or peripheral rim, while peritumoral bone marrow enhancement was assigned one of four grades. Correlation between the enhancement pattern and T2 signal intensity of a tumor was analyzed by fisher's exact test. The enhancement pattern was homogeneous in ten cases, heterogeneous in six, and involved the peripheral rim in seven. In 11 cases, peritumoral bone marrow enhancement was observed. Among the ten instances of homogeneous enhancement the signal intensity seen at T2W1 was homogeneously iso or low in six cases, homogeneously high in two, and heterogeneous in two. Among the seven cases in which three was peripheral rim enhancement, the signal intensity observed at T2W1 was homogeneously high in three, fluid-fluid level in three, and homogeneously iso or low in one. At MR imaging, chondroblastoma shows variable signal intensities and enhancement patterns. The peripheral rim enhancement observed at T2W1 correlated with homogeneously high signal intensity or fluid-fluid levels

  20. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results

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    Tins, Bernhard; Cassar-Pullicino, Victor; McCall, Iain [RJAH Orthopaedic and District Hospital, Department of Radiology, Oswestry (United Kingdom); Cool, Paul [RJAH Orthopaedic and District Hospital, Musculoskeletal Tumour Unit, Oswestry (United Kingdom); Williams, David [Hereford Hospital, Department of Orthopaedics, Hereford (United Kingdom); Mangham, David [RJAH Orthopaedic and District Hospital, Department of Pathology, Oswestry (United Kingdom)

    2006-04-15

    The standard treatment for chondroblastoma is surgery, which can be difficult and disabling due to its apo- or epiphyseal location. Radiofrequency (RF) ablation potentially offers a minimally invasive alternative. The often large size of chondroblastomas can make treatment with plain electrode systems difficult or impossible. This article describes the preliminary experience of RF treatment of chondroblastomas with a multi-tined expandable RF electrode system. Four cases of CT guided RF treatment are described. The tumour was successfully treated in all cases. In two cases, complications occurred; infraction of a subarticular chondroblastoma in one case and cartilage and bone damage in the unaffected compartment of a knee joint in the other. Radiofrequency treatment near a joint surface threatens the integrity of cartilage and therefore long-term joint function. In weight-bearing areas, the lack of bone replacement in successfully treated lesions contributes to the risk of mechanical failure. Multi-tined expandable electrode systems allow the treatment of large chondroblastomas. In weight-bearing joints and lesions near to the articular cartilage, there is a risk of cartilage damage and mechanical weakening of the bone. In lesions without these caveats, RF ablation appears promising. The potential risks and benefits need to be evaluated for each case individually. (orig.)

  1. Radiofrequency ablation of chondroblastoma using a multi-tined expandable electrode system: initial results

    International Nuclear Information System (INIS)

    The standard treatment for chondroblastoma is surgery, which can be difficult and disabling due to its apo- or epiphyseal location. Radiofrequency (RF) ablation potentially offers a minimally invasive alternative. The often large size of chondroblastomas can make treatment with plain electrode systems difficult or impossible. This article describes the preliminary experience of RF treatment of chondroblastomas with a multi-tined expandable RF electrode system. Four cases of CT guided RF treatment are described. The tumour was successfully treated in all cases. In two cases, complications occurred; infraction of a subarticular chondroblastoma in one case and cartilage and bone damage in the unaffected compartment of a knee joint in the other. Radiofrequency treatment near a joint surface threatens the integrity of cartilage and therefore long-term joint function. In weight-bearing areas, the lack of bone replacement in successfully treated lesions contributes to the risk of mechanical failure. Multi-tined expandable electrode systems allow the treatment of large chondroblastomas. In weight-bearing joints and lesions near to the articular cartilage, there is a risk of cartilage damage and mechanical weakening of the bone. In lesions without these caveats, RF ablation appears promising. The potential risks and benefits need to be evaluated for each case individually. (orig.)

  2. The MRI features of chondroblastoma with correlation of X-ray and CT findings

    International Nuclear Information System (INIS)

    Objective: To investigate the MR imaging features of chondroblastoma, and to address the correlation with findings of X-ray radiography and CT. Methods: The imaging findings including MRI, X-ray radiography and CT of 16 chondroblastomas proved by surgery and pathology were analyzed and correlated with each other. Results: All sixteen chondroblastomas involved the epiphyses of long bones, with varying sizes from 0.8 cm to 5.1 cm and lobulation. They were iso- and hypo-intense on T1WI and had heterogeneous signals on T2WI. They were of soft tissue density on CT, and had areas of calcifications and low density. The rims were hypointense on both T1WI and T2WI and showed hyperdensity on CT. The lesions were surrounded by edema of bone marrow which was hypointense on T1WI and hyperintense on fat suppressed T2WI, while on X-Ray film and CT it was hyperdense sclerotic area. The adjacent soft tissues were swelling. Nine cases had periosteal abnormalities on MRI in which 8 of 9 periosteal abnormalities were distant from the primary lesions, and 6 of them showed hyperdense perosteal new bone on CT. Twelve cases had joint effusion on MRI and CT detected 6 of them. The lesions had heterogeneous enhancement, and there was enhancement in areas of edema within bone marrow, periosteal reaction and adjacent soft tissue. Chondroblastoma was intermediate and hyperintense on DWI, and the intermediate areas on both T1WI and T2WI, together with areas of bone marrow edema, periosteal reaction and soft tissue swelling, were hyperintense on DWI. Conclusions: The MRI, X-ray and CT can reflect the pathological changes of chondroblastoma from different aspects. The characteristics of chondroblastoma can be better appreciated by combining different imaging methods. (authors)

  3. Chondroblastoma in the long bone diaphysis: a report of two cases with literature review

    Institute of Scientific and Technical Information of China (English)

    Jilong Yang; Wei Tian; Xiongzeng Zhu; Jian Wang

    2012-01-01

    To investigate the clinical characteristics of chondroblastoma with an emphasis on lesions located in the long bone diaphysis,we reviewed the clinical data of 7 patients with histologically proven chondroblastoma treated in Tianjin Medical University Cancer Hospital and Fudan University Cancer Hospital between January 1995 and May 2009.There were two rare cases of chondroblastoma in the long bone diaphysis.One patient with a lesion in the tibial diaphysis underwent intralesional curettage and bone grafting,and the postoperative bone function was measured as excellent according to the Enneking scoring system.The patient was still alive upon follow-up at 60 months.The other patient with a lesion in the humeral diaphysis underwent resection,and the postoperative bone function was excellent at 48 months,at which there was no evidence of recurrence or metastasis.Thus,except for the distinctive site of the long bone diaphysis,which made diagnosis difficult,the patients' ages,symptoms,X-ray and CT images,treatment,and prognosis were in accordance with typical lesions in the epiphysis and metaphysis.The diagnosis of chondroblastoma in the long bone diaphysis significantly depends on histopathologic characteristics.

  4. Chondroblastoma of the patella presentation of a case - National Institute of Cancerology ESE

    International Nuclear Information System (INIS)

    Chondroblastomas are infrequent neoplasic tumors, the world literature reports around seven hundred cases and only nine were located at the patella. We present the plain films and MR findings in a case of fifteen years old patient evaluated at the national cancer institute. The diagnosis was confirmed with pathologic analysis

  5. Chondroblastoma with secondary aneurysmal bone cyst in the anterior skull base

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    Ming Jie Wang, MD, PhD; Bing Zhou, MD

    2016-01-01

    Chondroblastoma with secondary aneurysmal bone cyst (ABC), especially in the anterior skull base, is an extremely rare condition. A 5-year-old boy presented with a large space-occupying lesion in the anterior skull base along with a left sided-epistaxis, proptosis and decreased vision. Radical excision of the lesion was performed by an endoscopic transnasal and transethmoidal approach. The patient recovered without any recurrence during a follow-up period of up to 28 months. Here, we review t...

  6. Radiofrequency ablation of chondroblastoma: long-term clinical and imaging outcomes

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    Xie, Cheng; Jeys, Lee [The Royal Orthopaedic Hospital Foundation Trust, Department of Oncology, Birmingham (United Kingdom); James, Steven L.J. [The Royal Orthopaedic Hospital Foundation Trust, Department of Radiology, Birmingham (United Kingdom)

    2015-04-01

    To investigate the long-term clinical and imaging outcomes of patients with chondroblastoma treated by radiofrequency ablation (RFA). Retrospective analysis of 25 consecutive patients treated with RFA from September 2006 to December 2013. Patients were reviewed within one month of the procedure, then every 3-6 months, and yearly for up to three years. Serial magnetic resonance imaging (MRI) was performed at follow-up to monitor recovery. Functional outcome was assessed using the Musculoskeletal Tumour Society Score (MSTS). Pre-procedure MRI confirmed osteolytic lesions (size range 1.0-3.3 cm; mean 2.0 cm). Patients reported continued symptomatic improvement at four months review. Serial MRI confirmed progressive resolution of inflammation with fatty consolidation of cavity. 88 % of patients became asymptomatic during the follow up period. Three patients' (12 %) symptoms returned at 16, 22 and 24 months respectively after RFA. MRI and biopsy confirmed recurrence in these patients. Functional assessment using MSTS score had an average score of 97.5 %. Mean follow up for the study group was 49 months. RFA is an effective alternative to surgery in the management of chondroblastoma. We recommend a multi-disciplinary approach and RFA should be considered as a first-line treatment. Long-term follow-up is required for timely detection of recurrences. (orig.)

  7. A chondroblastoma versus a giant cell tumor: emphasis on the MR imaging features

    International Nuclear Information System (INIS)

    To assess the MR imaging features in differentiating a chondroblastoma (CB) from a giant cell tumor (GCT), with an emphasis on the accompanying peritumoral bone marrow edema. MR imaging findings in 20 patients with CB were compared with the imaging features of 22 patients with GCT. The location of the lesion, signal intensity, adjacent cortical change, degree of accompanying bone marrow edema, synovitis in the adjacent joint and cystic change were analyzed. The findings of CB and GCT were examined statistically with use of Fisher's exact test. The incidence ratios of MR imaging findings were as follows (CB:GCT). Metaphyseal dominant involvement (2:21), partial cortical disruption (2:14), extensive bone marrow edema surrounding the tumor (14:0) and synovitis in the adjacent joint (11:2) were statistically different in incidence between CB and GCT (ρ < 0.01). The inhomogeneous signal intensity (17:17) and cystic change (10:15) were not different in incidence between a CB and GCT. The presence of metaphyseal dominant involvement and cortical disruption favors a diagnosis of a GCT rather than a CB. In contrast, extensive bone marrow edema surrounding the tumor and synovitis in the adjacent joint are highly indicative of a CB

  8. An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique

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    Rakočević Zoran

    2010-07-01

    Full Text Available Abstract This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature.

  9. Dual-time-point FDG-PET/CT Imaging of Temporal Bone Chondroblastoma: A Report of Two Cases

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    Akira Toriihara

    2015-07-01

    Full Text Available Temporal bone chondroblastoma is an extremely rare benign bone tumor. We encountered two cases showing similar imaging findings on computed tomography (CT, magnetic resonance imaging (MRI, and dual-time-point 18F-fluorodeoxyglucose (18F-FDG positron emission tomography (PET/CT. In both cases, CT images revealed temporal bone defects and sclerotic changes around the tumor. Most parts of the tumor showed low signal intensity on T2- weighted MRI images and non-uniform enhancement on gadolinium contrast-enhanced T1-weighted images. No increase in signal intensity was noted in diffusion-weighted images. Dual-time-point PET/CT showed markedly elevated 18F-FDG uptake, which increased from the early to delayed phase. Nevertheless, immunohistochemical analysis of the resected tumor tissue revealed weak expression of glucose transporter-1 and hexokinase II in both tumors. Temporal bone tumors, showing markedly elevated 18F-FDG uptake, which increases from the early to delayed phase on PET/CT images, may be diagnosed as malignant bone tumors. Therefore, the differential diagnosis should include chondroblastoma in combination with its characteristic findings on CT and MRI.

  10. A balanced t(5;17) (p15;q22-23) in chondroblastoma: frequency of the re-arrangement and analysis of the candidate genes

    International Nuclear Information System (INIS)

    Chondroblastoma is a benign cartilaginous tumour of bone that predominantly affects the epiphysis of long bones in young males. No recurrent chromosomal re-arrangements have so far been observed. Methods: We identified an index case with a balanced translocation by Combined Binary Ratio-Fluorescent in situ Hybridisation (COBRA-FISH) karyotyping followed by breakpoint FISH mapping and array-Comparative Genomic Hybridisation (aCGH). Candidate region re-arrangement and candidate gene expression were subsequently investigated by interphase FISH and immunohistochemistry in another 14 cases. A balanced t(5;17)(p15;q22-23) was identified. In the index case, interphase FISH showed that the translocation was present only in mononucleated cells and was absent in the characteristic multinucleated giant cells. The t(5;17) translocation was not observed in the other cases studied. The breakpoint in 5p15 occurred close to the steroid reductase 5α1 (SRD5A1) gene. Expression of the protein was found in all cases tested. Similar expression was found for the sex steroid signalling-related molecules oestrogen receptor alpha and aromatase, while androgen receptors were only found in isolated cells in a few cases. The breakpoint in 17q22-23 was upstream of the carbonic anhydrase × (CA10) gene region and possibly involved gene-regulatory elements, which was indicated by the lack of CA10 protein expression in the index case. All other cases showed variable levels of CA10 expression, with low expression in three cases. We report a novel t(5;17)(p15;q22-23) translocation in chondroblastoma without involvement of any of the two chromosomal regions in other cases studied. Our results indicate that the characteristic multinucleated giant cells in chondroblastoma do not have the same clonal origin as the mononuclear population, as they do not harbour the same translocation. We therefore hypothesise that they might be either reactive or originate from a distinct neoplastic clone, although the

  11. 少见部位软骨母细胞瘤的影像诊断%Imaging diagnosis of chondroblastoma in unusual locations

    Institute of Scientific and Technical Information of China (English)

    戴灼南; 司建荣

    2012-01-01

    Objective:To investigate the imaging features and their value in the diagnosis of chondroblastoma in unusual locations. Methods:The clinical materials of 7 cases with pathology proved chondroblastoma in unusual locations were retrospectively analyzed,involving talus (n=2) .calcaneus (n = 2) ,patella,ischial tuberosity and inferior ramus of pubis for one case each. In these 7 patients, plain radiography (n= 7) ,computed tomography (n=4) and magnetic resonance imaging (n=4) were performed. Results:Expansive bone destruction (n=5) and cystic bone destrution (n= 1) were assessed on radiography, also patchy sclerosis around the lesion (n=3) and intra-tumoral spotty calcifications (n=l). Of the 4 cases undergone CT, there were expansive bone destruction, patchy sclerosis around the lesion and intra-tumoral patchy or spotty calcifications. Expansive bone destruction were showed in 3 cases on MRI with heterogeneous signal intensities. peripheral linear hypo-intensity and obvious bone marrow edema. Conclusion; Imaging features of chondroblastoma in unusual locations included expansive destruction of bone,and peripheral bone marrow edema. Combined utilization of plain films,CT and MRI is helpful for the diagnosis and differential diagnosis of chondroblastoma in unusual locations.%目的:探讨少见部位软骨母细胞瘤的影像学表现及其临床诊断价值.方法:回顾性分析经病理证实的7例少见部位软骨母细胞瘤患者的病例资料.肿瘤位于距骨2例、跟骨2例、髌骨、坐骨结节及耻骨下支各1例.行X线平片检查7例,CT平扫4例,MRI平扫及增强检查4例.结果:X线平片示膨胀性骨质破坏5例,囊状骨质破坏1例,灶周硬化3例,病灶内小斑片状钙化1例;平片漏诊1例.4例CT均显示膨胀性骨质破坏,灶周硬化,病灶内斑点状或小斑片状钙化.MRI上病变呈膨胀性骨质破坏3例,囊状骨质破坏1例,4例病灶信号均混杂,灶周均可见低信号线状影及明显的骨髓水肿.结

  12. 软骨母细胞瘤MRI及X线平片和CT的表现特征%The MRI features of chondroblastoma with correlation of X-ray and CT findings

    Institute of Scientific and Technical Information of China (English)

    上官景俊; 刘吉华; 韩娟娟; 邢成颜

    2008-01-01

    目的 研究软骨母细胞瘤的影像表现,探讨其MRI与X线平片、CT征象的对应关系.方法 分析16例经手术、病理证实的良性软骨母细胞瘤的影像资料,总结其MRI表现与X线平片、CT征象的对应关系.结果 16例软骨母细胞瘤均位于骨骺,大小为0.9 cm×0.8 cm×1.0 cm~4.8 cm×4.3 cm×5.1 cm,呈不同程度的分叶状.在T1WI上以等、低信号为主,T2WI上呈混杂信号,CT上为软组织密度,内见钙化和更低密度区.边缘呈长T1、短T2信号,在CT上表现为硬化边.MRI可见病灶周围有骨髓水肿,在X线和CT上表现为骨质硬化区.病灶邻近软组织肿胀.MRI显示骨膜异常9例,8例与病灶不相邻;X线和(或)CT显示骨膜新生骨6例.MRI显示关节积液12例,CT显示6例.MRI上病灶均呈不均匀强化,骨髓水肿、骨膜反应和软组织肿胀均见强化.软骨母细胞瘤在扩散加权成像(DWI)上呈等、高信号,在MR平扫中的等T1、等T2成分和长T1、长T2成分,以及骨髓水肿、骨膜反应和软组织肿胀在DWI上均呈高信号.结论 MRI和X线平片、CT从不同方面反映软骨母细胞瘤的病理改变,联合应用不同检查手段可更全面显示软骨母细胞瘤的特点.%Objective To investigate the MR imaging features of chondroblastoma,and to address the correlation with findings of X-ray radiography and CT.Methods The imaging findings including MRI,X-ray radiography and CT of 16 chondroblastomas proved by surgery and pathology were analyzed and correlated with each other. Results All sixteen chondroblastomas involved the epiphyses of long bones,with varying sizes from 0.8 cm to 5.1 cm and lobulation. They were iso- and hypo-intense on T1WI and had heterogeneous signals on T2WI.They were of soft tissue density on CT,and had areas of calcifications and low density.The rims were hypointense on both T1 WI and T2 WI and showed hyperdensity on CT. The lesions were surrounded by edema of bone marrow which was hypointense on T1 WI

  13. Chrondoblastoma of the patella

    Energy Technology Data Exchange (ETDEWEB)

    Moser, R.P. Jr.; Brockmole, D.M.; Vinh, T.N.; Kransdorf, M.J.; Aoki, J.

    1988-09-01

    This study reviews 16 cases of chondroblastoma of the patella which constitute mearly 6% of a large group of chondroblastomas scattered throughout the skeleton. Both radiologic and histologic appearances of chondroblastomas of the patella are indistinguishable from those of chondroblastomas arising in other sites. A reasonable differential diagnosis, including chondromalacia patella, is discussed together with important therapeutic considerations.

  14. Imaging tumors of the patella

    International Nuclear Information System (INIS)

    Background: Patellar tumors are rare; only a few series have been described in the literature and radiographic diagnosis can be challenging. We reviewed all patellar tumors at one institution and reviewed the literature. Materials and methods: In an evaluation of the database at one institution from 1916 to 2009, 23,000 bone tumors were found. Of these, 41 involved the patella. All had imaging studies and microscopic diagnostic confirmation. All medical records, imaging studies, and pathology were reviewed. Results: There were 15 females and 26 males, ranging from 8 to 68 years old (average 30). There were 30 benign tumors; eight giant cell tumors, eight chondroblastomas, seven osteoid osteomas, two aneurysmal bone cysts, two ganglions, one each of chondroma, exostosis, and hemangioma. There were 11 malignant tumors: five hemangioendotheliomas, three metastases, one lymphoma, one plasmacytoma, and one angiosarcoma. Conclusion: Patellar tumors are rare and usually benign. As the patella is an apophysis, the most frequent lesions are giant cell tumor in the adult and chondroblastoma in children. Osteoid osteomas were frequent in our series and easily diagnosed. Metastases are the most frequent malignant diagnoses in the literature; in our series malignant vascular tumors were more common. These lesions are often easily analyzed on radiographs. CT and MR define better the cortex, soft tissue extension, and fluid levels. This study presents the imaging patterns of the more common patellar tumors in order to help the radiologist when confronted with a lesion in this location

  15. Tumour and tumour-like lesions of the patella - a multicentre experience

    Energy Technology Data Exchange (ETDEWEB)

    Singh, J.; James, S.L.; Davies, A.M. [The Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Kroon, H.M. [Leiden University Medical Centre, Department of Radiology, C-2-S, P. O Box 9600, Leiden (Netherlands); Woertler, K. [Technische Universitaet Muenchen, Department of Radiology, Munich (Germany); Anderson, S.E. [Knochentumor- Referenzzentrum der Schweizerischen Gesellschaft fuer Pathologie, Basel (Switzerland)

    2009-03-15

    Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions. (orig.)

  16. Extraskeletal Osteosarcoma of Penis: A Case Report

    Institute of Scientific and Technical Information of China (English)

    Chuan-zhen Wu; Cheng-mei Li; Song Han; Shuang Wu

    2012-01-01

    Extraskeletal osteosarcoma (EOS) is rare and commonly arises in the retroperitoneum,limbs,head and neck.There is no significant difference between EOS and other malignant tumors in soft tissue.Localized pain and swelling are the common presenting symptoms.Clinical diagnosis of EOS is difficult,imaging techniques may be helpful and careful,and the histopathological analysis is necessary.The common histological variants of EOS include:osteoblastoma,chondroblastoma,and fibroblastoma,and other unusual subtypes were reported occasionally.It should be distinguished with myositis ossificans,malignant mesenchymoma,giant cell tumor and parosteal osteosarcoma.We present an EOS arising in the penis.The primary site and histological category of the tumor were extremely rare.We hope the case will be helpful to the recognition of clinical signs,iconography and histopathology of EOS.

  17. Molecular basis for oncohistone H3 recognition by SETD2 methyltransferase.

    Science.gov (United States)

    Yang, Shuang; Zheng, Xiangdong; Lu, Chao; Li, Guo-Min; Allis, C David; Li, Haitao

    2016-07-15

    High-frequency point mutations of genes encoding histones have been identified recently as novel drivers in a number of tumors. Specifically, the H3K36M/I mutations were shown to be oncogenic in chondroblastomas and undifferentiated sarcomas by inhibiting H3K36 methyltransferases, including SETD2. Here we report the crystal structures of the SETD2 catalytic domain bound to H3K36M or H3K36I peptides with SAH (S-adenosylhomocysteine). In the complex structure, the catalytic domain adopts an open conformation, with the K36M/I peptide snuggly positioned in a newly formed substrate channel. Our structural and biochemical data reveal the molecular basis underying oncohistone recognition by and inhibition of SETD2. PMID:27474439

  18. Clival Lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

    International Nuclear Information System (INIS)

    An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

  19. [Chondromyxoid fibroma of bone: a rare benign bone tumor in children].

    Science.gov (United States)

    Rouas, L; Malihy, A; Cherradi, N; Lamalmi, N; Alhamany, Z

    2004-12-01

    Chondromyxoid fibroma is a rare benign tumor that is typically found in the metaphyseal ends of long tubular bones, such as the tibia. The radiographic appearances are those of a single, lytic lesion with lobulated margins, septations, cortical expansion and a sclerotic rim. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Two cases are presented here: 8, and 12-year-old patients, both with lesions in the proximal tibia. The first case showed an unusual feature: it was diaphyseal chondromyxoid fibroma. In the second case, the lesion was metaphyso-diaphyseal. The differential diagnosis includes chondroblastoma, myxoma, aneurysmal cyst as well as chondrosarcoma. A surgical conservative treatment with complete excision is recommended even in case of recurrence. PMID:15688891

  20. [Chondromyxoid fibroma. Morphological variations, site, incidence, radiologic criteria and differential diagnosis].

    Science.gov (United States)

    Engels, C; Priemel, M; Möller, G; Werner, M; Delling, G

    1999-07-01

    Chondromyxoid fibroma is a rare benign bone tumor, accounting for less than 1% of all bone tumors. The peak age incidence is the second and third decade of life. Chondromyxoid fibrom occurs in the metaphyseal parts of the major tubular bones, predominantly of the lower extremity. Roentgenograms show, in most cases, a well-demarcated radiolucent lesion. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Analysis of 40 chondromyxoid fibromas demonstrates the morphological variation of this tumor. Cases were examined for age distribution, localization, and radiological and histological features. In 85% we found the typical histomorphological pattern. Recurrence rate was 12.5%. In four cases the appearance was uncharacteristic and differentiation from other tumors such as chondroblastoma or chondrosarcoma was quite difficult. By adhering to strict histomorphological criteria, definite diagnosis of chondromyxoid fibroma can be made in most cases. PMID:10478364

  1. Osteoblastoma. Peritumoral radiological changes

    International Nuclear Information System (INIS)

    It is a well-known fact that peritumoral radiological changes are observed in certain benign tumors, such as osteoid osteoma and chondroblastoma. In a series of eight osteoblastoma patients, we detected four cases of peritumoral changes using one or more of the following imaging techniques: plain radiography, computed tomography, magnetic resonance, gamma scintigraphy and arteriography. The radiological changes are described and classified as distant periostitis, regional osteoporosis, soft tissue changes, diffuse radiolabel uptake, extensive capillary hypervascularization and staining, and changes in magnetic resonance signal. We discuss the pathophysiology of the peritumoral inflammatory edema induced by the prostaglandins produced by some of these tumors. Moreover, we stress the importance of assessing the entire set of imaging studies, no only to determine the definitive diagnosis but to avoid confusing these lesions with malignant tumors as a result of the overestimation of their extension and aggressiveness. (Author) 15 refs

  2. Tumour and tumour-like lesions of the patella - a multicentre experience

    International Nuclear Information System (INIS)

    Fifty-nine cases of lesions presenting in the patella were identified after review of the databases of four European bone tumour registries. Of the 59 cases, 46% were non neoplastic, 39% were benign and 15% were malignant. The commonest benign neoplasm was giant cell tumour (GCT) (11 cases). Younger patients were more likely to have a benign neoplasm. Lesions in patients less than 40 years of age included giant cell tumour, chondroblastoma, aneurysmal bone cyst (ABC), osteomyelitis, osteoid osteoma and solitary bone cyst. In patients older than 40 years, the following were common lesions: intra-osseous gout, metastasis and intra-osseous ganglion. Expansion of the patella with thinning of cortex was seen more commonly in GCT and brown tumour in hyperparathyroidism. There was associated soft tissue extension in gout and malignant lesions. (orig.)

  3. Clival Lesion incidentally discovered on cone-beam computed tomography: A case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Jadhav, Aniket B.; Tadinada, Aditya; Rengasamy, Kandasamy; Lurie, Alan G. [Dept. of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine, Farmington (United States); Douglas, Fellows [Division of Diagnostic Sciences and Therapeutics, University of Connecticut School of Medicine, Farmington (United States)

    2014-06-15

    An osteolytic lesion with a small central area of mineralization and sclerotic borders was discovered incidentally in the clivus on the cone-beam computed tomography (CBCT) of a 27-year-old male patient. This benign appearance indicated a primary differential diagnosis of non-aggressive lesions such as fibro-osseous lesions and arrested pneumatization. Further, on magnetic resonance imaging (MRI), the lesion showed a homogenously low T1 signal intensity with mild internal enhancement after post-gadolinium and a heterogeneous T2 signal intensity. These signal characteristics might be attributed to the fibrous tissues, chondroid matrix, calcific material, or cystic component of the lesion; thus, chondroblastoma and chondromyxoid fibroma were added to the differential diagnosis. Although this report was limited by the lack of final diagnosis and the patient lost to follow-up, the incidental skull base finding would be important for interpreting the entire volume of CBCT by a qualified oral and maxillofacial radiologist.

  4. Molecular Pathogenesis and Diagnostic, Prognostic and Predictive Molecular Markers in Sarcoma.

    Science.gov (United States)

    Mariño-Enríquez, Adrián; Bovée, Judith V M G

    2016-09-01

    Sarcomas are infrequent mesenchymal neoplasms characterized by notable morphological and molecular heterogeneity. Molecular studies in sarcoma provide refinements to morphologic classification, and contribute diagnostic information (frequently), prognostic stratification (rarely) and predict therapeutic response (occasionally). Herein, we summarize the major molecular mechanisms underlying sarcoma pathogenesis and present clinically useful diagnostic, prognostic and predictive molecular markers for sarcoma. Five major molecular alterations are discussed, illustrated with representative sarcoma types, including 1. the presence of chimeric transcription factors, in vascular tumors; 2. abnormal kinase signaling, in gastrointestinal stromal tumor; 3. epigenetic deregulation, in chondrosarcoma, chondroblastoma, and other tumors; 4. deregulated cell survival and proliferation, due to focal copy number alterations, in dedifferentiated liposarcoma; 5. extreme genomic instability, in conventional osteosarcoma as a representative example of sarcomas with highly complex karyotype. PMID:27523972

  5. Chondrogenic Lesions of the Skeletal System Using Radiographs, CT and MRI

    Directory of Open Access Journals (Sweden)

    Akbar Bonakdarpour

    2011-05-01

    Full Text Available Benign Tumors: Chondroma, chondroblastoma,"nchondromyxoid fibroma, osteochondroma"nChondroma"n1. Enchondroma"n2. Periosteal Chondroma"n3. Enchondromatosis"n4. Metachondromatosis"nEnchondroma is a benign metaphyseal tumor. The"nmajor differential diagnoses are bone infarct and"nchondrosarcoma. Calcification in enchondroma"nhas a popcorn appearance and on radiographs and"nCT they may be counted. Calcified bone infarct"nhas an appearance similar to rotten metal. Central"nchondrosarcoma shows cortical erosion more than"ntwo thirds of the thickness of cortex and also periosteal"nreaction. Pain and growth of lesion in adulthood raises"nthe possibility of malignant transformation."nPeriosteal chondroma: This lesion arises from the"nperiosteum without involving the medullary bone."nThe most common location is the upper humerus."nEnchondromatosis reveals multiple enchondromas,"npredominantly involving one side of the skeleton."nMalignant transformation is the major complication"nof enchondromatosis. In malignant transformation,"nMRI shows that perichondrium is more than 1 cm"nthick in adults and more than 3 cm thick in children."nIn the hands and feet, enchondromatosis should not"nbe confused with fibrous dysplasia. Mafucci syndrome"nis enchondromatosis associated with cavernous"nhemangiomas with a prognosis worse than enchondr"nomatosis."nMultiple hereditary cartilaginous exostoses: This is"nof metaphyseal origin and pedunculated forms grow"naway from the adjacent joint. Sessile osteochondromas"nare broad based; if their surface is irregular they are"nsuspicious of malignancy. Pain and growth of the"nlesion after closure of the epiphyseal plate are warning"nsigns of malignant transformation. In malignant"ntransformation MRI shows that perichondrium is"nmore than 1 cm thick in adults and more than 3 cm"nthick in children."nChondroblastoma: This is a benign tumor, seen before"nclosure of epiphyseal plate, with a sclerotic border."n30 to 50% show

  6. Can p63 serve as a biomarker for giant cell tumor of bone? A Moroccan experience

    Directory of Open Access Journals (Sweden)

    Hammas Nawal

    2012-09-01

    Full Text Available Abstract Background Multinucleated giant cell-containing tumors and pseudotumors of bone represent a heterogeneous group of benign and malignant lesions. Differential diagnosis can be challenging, particularly in instances of limited sampling. The purpose of this study was to evaluate the contribution of the P63 in the positive and differential diagnosis of giant cell tumor of bone. Methods This study includes 48 giant cell-containing tumors and pseudotumors of bone. P63 expression was evaluated by immunohistochemistry. Data analysis was performed using Epi-info software and SPSS software package (version 17. Results Immunohistochemical analysis showed a P63 nuclear expression in all giant cell tumors of bone, in 50% of osteoid osteomas, 40% of aneurysmal bone cysts, 37.5% of osteoblastomas, 33.3% of chondromyxoide fibromas, 25% of non ossifiant fibromas and 8.3% of osteosarcomas. Only one case of chondroblastoma was included in this series and expressed p63. No P63 immunoreactivity was detected in any of the cases of central giant cell granulomas or langerhans cells histiocytosis. The sensitivity and negative predictive value (NPV of P63 immunohistochemistry for the diagnosis of giant cell tumor of bone were 100%. The specificity and positive predictive value (PPV were 74.42% and 59.26% respectively. Conclusions This study found not only that GCTOB expresses the P63 but it also shows that this protein may serve as a biomarker for the differential diagnosis between two morphologically similar lesions particularly in instances of limited sampling. Indeed, P63 expression seems to differentiate between giant cell tumor of bone and central giant cell granuloma since the latter does not express P63. Other benign and malignant giant cell-containing lesions express P63, decreasing its specificity as a diagnostic marker, but a strong staining was seen, except a case of chondroblastoma, only in giant cell tumor of bone. Clinical and radiological

  7. Bony sequestrum: A radiologic review

    Energy Technology Data Exchange (ETDEWEB)

    Jennin, Felicie; Bousson, Valerie; Parlier, Caroline; Jomaah, Nabil; Khanine, Vanessa; Laredo, Jean-Denis [Lariboisiere Hospital, Department of Radiology, Paris (France)

    2011-08-15

    According to a pathological definition, a bony sequestrum is defined as a piece of devitalized bone that has been separated from the surrounding bone during the process of necrosis. However, the radiological definition of a sequestrum is different and refers to an image of calcification visible within a lucent lesion, completely separated from the surrounding bone, without referring to the vascular status and histological nature of the calcified tissue. The term ''button sequestrum'' has been used in calvarial lesions. The prototype conditions that may present with a bony sequestrum are osteomyelitis and skeletal tuberculosis. Other conditions such as radiation necrosis, eosinophilic granuloma, metastatic carcinoma, primary lymphoma of bone, aggressive fibrous tumors may also manifest as osteolytic lesions containing a sequestrum. In addition, some primary bone tumors produce a matrix that may mineralize and sometimes simulate a bone sequestrum. These include osteoid tumors (osteoid osteoma, osteoblastoma), cartilaginous tumors (chondroma and chondroblastoma), lipomatous tumors (lipoma), and benign fibrous tumors (fibromyxoma, myxoma, and desmoplastic fibroma). Therefore, various conditions may present at imaging as a small area of osteolysis containing central calcifications. However, a careful analysis of the sequestrum as well as the associated clinical and radiological findings often enables to point toward a limited number of conditions. (orig.)

  8. Fluid-fluid level on MR image: significance in Musculoskeletal diseases

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Hye Won; Lee, Kyung Won [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine; Song, Chi Sung [Seoul City Boramae Hospital, Seoul (Korea, Republic of); Han, Sang Wook; Kang, Heung Sik [Seoul Naitonal University, Seoul (Korea, Republic of). Coll. of Medicine

    1998-01-01

    To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs.

  9. Fluid-fluid level on MR image: significance in Musculoskeletal diseases

    International Nuclear Information System (INIS)

    To evaluate the frequency, number and signal intensity of fluid-fluid levels of musculoskeletal diseases on MR images, and to determine the usefulness of this information for the differentiation of musculoskeletal diseases. MR images revealed fluid-fluid levels in the following diseases : giant cell tumor(6), telangiectatic osteosarcoma(4), aneurysmal bone cyst(3), synovial sarcoma(3), chondroblastoma(2), soft tissue tuberculous abscess(2), hematoma(2), hemangioma (1), neurilemmoma(1), metastasis(1), malignant fibrous histiocytoma(1), bursitis(1), pyogenic abscess(1), and epidermoid inclusion cyst(1). Fourteen benign tumors and ten malignant, three abscesses, and the epidermoid inclusion cyst showed only one fluid-fluid level in a unilocular cyst. On T1-weighted images, the signal intensities of fluid varied, but on T2-weighted images, superior layers were in most cases more hyperintense than inferior layers. Because fluid-fluid layers are a nonspecific finding, it is difficult to specifically diagnose each disease according to the number of fluid-fluid levels or signal intensity of fluid. In spite of the nonspecificity of fluid-fluid levels, they were frequently seen in cases of giant cell tumor, telangiectatic osteosarcoma, aneurysmal bone cycle, and synovial sarcoma. Nontumorous diseases such abscesses and hematomas also demonstrated this finding. (author). 11 refs., 1 tab., 4 figs

  10. Osteoid osteoma and osteoid osteoma-mimicking lesions: biopsy findings, distinctive MDCT features and treatment by radiofrequency ablation

    International Nuclear Information System (INIS)

    To report the biopsy findings of osteoid osteoma (OO) and OO-mimicking lesions, assess their distinctive multidetector computed tomography (MDCT) features and evaluate treatment by radiofrequency ablation (RFA). In this multicentric retrospective study, 80 patients (54 male, 26 female, mean age 24.1 years, range 5-48) with presumed (clinical and MDCT features) OO were treated by percutaneous RFA between May 2002 and June 2009. Per-procedural biopsies were always performed. The following MDCT features were assessed: skeletal distribution and location within the bone, size, central calcification, surrounding osteosclerosis and periosteal reaction. Clinical success of RFA was evaluated. Histopathological diagnoses were: 54 inconclusive biopsies, 16 OO, 10 OO-mimicking lesions (5 chronic osteomyelitis, 3 chondroblastoma, 1 eosinophilic granuloma, 1 fibrous dysplasia). OO-mimicking lesions were significantly greater in size (p = 0.001) and presented non-significant trends towards medullary location (p = 0.246), moderate surrounding osteosclerosis (p = 0.189) and less periosteal reaction (p = 0.197), compared with OO. Primary success for ablation of OO-mimicking lesions was 100% at 1 month, 85.7% at 6 and 12 months, and 66.7% at 24 months. Secondary success was 100%. Larger size, medullary location, less surrounding osteosclerosis and periosteal reaction on MDCT may help differentiate OO-mimicking lesions from OO. OO-mimicking lesions are safely and successfully treated by RFA. (orig.)

  11. Osteoid osteoma and osteoid osteoma-mimicking lesions: biopsy findings, distinctive MDCT features and treatment by radiofrequency ablation

    Energy Technology Data Exchange (ETDEWEB)

    Becce, Fabio [Centre Hospitalier Universitaire Vaudois, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Universite Paris Descartes, Department of Radiology B, Hopital Cochin, AP-HP, Paris (France); Theumann, Nicolas [Centre Hospitalier Universitaire Vaudois, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Rochette, Antoine; Campagna, Raphael; Drape, Jean-Luc; Feydy, Antoine [Universite Paris Descartes, Department of Radiology B, Hopital Cochin, AP-HP, Paris (France); Larousserie, Frederique [Universite Paris Descartes, Department of Anatomic Pathology, Hopital Cochin, AP-HP, Paris (France); Cherix, Stephane; Mouhsine, Elyazid [Centre Hospitalier Universitaire Vaudois, Department of Orthopaedic and Traumatologic Surgery, Lausanne (Switzerland); Guillou, Louis [University Institute of Pathology, Centre Hospitalier Universitaire Vaudois, Lausanne (Switzerland); Anract, Philippe [Universite Paris Descartes, Department of Orthopaedic Surgery, Hopital Cochin, AP-HP, Paris (France)

    2010-10-15

    To report the biopsy findings of osteoid osteoma (OO) and OO-mimicking lesions, assess their distinctive multidetector computed tomography (MDCT) features and evaluate treatment by radiofrequency ablation (RFA). In this multicentric retrospective study, 80 patients (54 male, 26 female, mean age 24.1 years, range 5-48) with presumed (clinical and MDCT features) OO were treated by percutaneous RFA between May 2002 and June 2009. Per-procedural biopsies were always performed. The following MDCT features were assessed: skeletal distribution and location within the bone, size, central calcification, surrounding osteosclerosis and periosteal reaction. Clinical success of RFA was evaluated. Histopathological diagnoses were: 54 inconclusive biopsies, 16 OO, 10 OO-mimicking lesions (5 chronic osteomyelitis, 3 chondroblastoma, 1 eosinophilic granuloma, 1 fibrous dysplasia). OO-mimicking lesions were significantly greater in size (p = 0.001) and presented non-significant trends towards medullary location (p = 0.246), moderate surrounding osteosclerosis (p = 0.189) and less periosteal reaction (p = 0.197), compared with OO. Primary success for ablation of OO-mimicking lesions was 100% at 1 month, 85.7% at 6 and 12 months, and 66.7% at 24 months. Secondary success was 100%. Larger size, medullary location, less surrounding osteosclerosis and periosteal reaction on MDCT may help differentiate OO-mimicking lesions from OO. OO-mimicking lesions are safely and successfully treated by RFA. (orig.)

  12. [Genetic Aberration and Pathological Diagnosis in Bone and Soft-Tissue Tumors].

    Science.gov (United States)

    Iura, Kunio; Oda, Yoshinao

    2016-03-01

    Bone and soft-tissue sarcomas comprise a rare, complex, and heterogeneous group of tumors for which it is difficult for even experienced pathologists to provide a conclusive diagnosis. The number of diagnoses made using genetic analysis has increased since the detection of fusion genes in several soft-tissue tumors in the 1990s. Moreover, other specific genetic aberrations have been reported in various bone and soft-tissue tumors. In addition, molecular therapeutic targets have been sought in advanced cases of soft-tissue and bone tumors similar to other organ malignancies. To enable the pathological diagnosis of bone and soft-tissue tumors, it is necessary to combine histological diagnosis with immunohistochemistry and gene analysis findings including fusion gene or other genetic aberrations. In this review, we describe the fusion genes recently reported in bone and soft-tissue tumors such as solitary fibrous tumor, aneurysmal bone cyst, nodular fasciitis, CIC-DUX4 fusion gene-positive small round cell tumors, or BCOR-CCNB3-positive sarcoma as well as other genetic aberrations in dedifferentiated liposarcoma, malignant rhabdoid tumor, cartilaginous tumor, Langerhans cell histiocytosis chondroblastoma, or giant cell tumor of the bone. We also demonstrate their association with pathological diagnosis. PMID:27067846

  13. Bony sequestrum: A radiologic review

    International Nuclear Information System (INIS)

    According to a pathological definition, a bony sequestrum is defined as a piece of devitalized bone that has been separated from the surrounding bone during the process of necrosis. However, the radiological definition of a sequestrum is different and refers to an image of calcification visible within a lucent lesion, completely separated from the surrounding bone, without referring to the vascular status and histological nature of the calcified tissue. The term ''button sequestrum'' has been used in calvarial lesions. The prototype conditions that may present with a bony sequestrum are osteomyelitis and skeletal tuberculosis. Other conditions such as radiation necrosis, eosinophilic granuloma, metastatic carcinoma, primary lymphoma of bone, aggressive fibrous tumors may also manifest as osteolytic lesions containing a sequestrum. In addition, some primary bone tumors produce a matrix that may mineralize and sometimes simulate a bone sequestrum. These include osteoid tumors (osteoid osteoma, osteoblastoma), cartilaginous tumors (chondroma and chondroblastoma), lipomatous tumors (lipoma), and benign fibrous tumors (fibromyxoma, myxoma, and desmoplastic fibroma). Therefore, various conditions may present at imaging as a small area of osteolysis containing central calcifications. However, a careful analysis of the sequestrum as well as the associated clinical and radiological findings often enables to point toward a limited number of conditions. (orig.)

  14. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Dyck, P. van; Venstermans, C.; Gielen, J.; Parizel, P.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, F.M. [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten, Department of Radiology, Duffel/Mechelen (Belgium); Vogel, J. [Leiden University Medical Centre, Department of Orthopedics, Leiden (Netherlands); Kroon, H.M.; Bloem, J.L. [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Schepper, A.M.A. de [University Hospital Antwerp, Department of Radiology, Edegem (Belgium); Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands)

    2006-12-15

    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can

  15. Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), ''brown tumor'' (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma ''not otherwise specified'' (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can occur in a wide range of bone and soft

  16. Curettage of benign bone tumors and tumor like lesions: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Zile Singh Kundu

    2013-01-01

    Full Text Available Background: Curettage is one of the most common treatment options for benign lytic bone tumors and tumor like lesions. The resultant defect is usually filled. We report our outcome curettage of benign bone tumors and tumor like lesions without filling the cavity. Materials and Methods: We retrospectively studied 42 patients (28 males and 14 females with benign bone tumors who had undergone curettage without grafting or filling of the defect by any other bone graft substitute. The age of the patients ranged from 14 to 66 years. The most common histological diagnosis was that of giant cell tumor followed by simple bone cyst, aneurysamal bone cyst, enchondroma, fibrous dysplasia, chondromyxoid fibroma, and chondroblastoma and giant cell reparative granuloma. Of the 15 giant cell tumors, 4 were radiographic grade 1 lesions, 8 were grade 2 and 3 grade 3. The mean maximum diameter of the cysts was 5.1 (range 1.1-9 cm cm and the mean volume of the lesions was 34.89 cm 3 (range 0.94-194.52 cm 3 . The plain radiographs of the part before and after curettage were reviewed to establish the size of the initial defect and the rate of reconstitution, filling and remodeling of the bone defect. Patients were reviewed every 3 monthly for a minimum period of 2 years. Results: Most of the bone defects completely reconstituted to a normal appearance while the rest filled partially. Two patients had preoperative and three had postoperative fractures. All the fractures healed uneventfully. Local recurrence occurred in three patients with giant cell tumor who were then reoperated. All other patients had unrestricted activities of daily living after surgery. The rate of bone reconstitution, risk of subsequent fracture or the incidence of complications was related to the size of the cyst/tumor at diagnosis. The benign cystic bone lesions with volume greater than approximately 70 cm 3 were found to have higher incidence of complications. Conclusion: This study

  17. The imaging characteristics of primary bone tumors less than 3 cm in diameter (an analysis of 57 cases)

    International Nuclear Information System (INIS)

    Objective: To analyze the imaging findings of primary bone tumors less than 3 cm in diameter, and to evaluate their imaging characteristics. Methods: Out of 400 cases of primary bone tumors, 57 cases less than 3 cm in diameter (0.6-3.0 cm, mean 1.6 cm) were retrospectively analyzed. There were 33 males and 24 females, and their age ranged from 3.5 to 80.0 years (mean 25.0 years). 31 of the 57 cases were younger than 14 years. 55 cases were benign tumors and 2 were malignant. Radiography was performed in all 57 cases, CT in 16 cases, and MR in 7. Results: X-ray and CT of osteoma showed clearly demarcated and homogeneous bony density (n=9) and inhomogeneous bony density with spot-like higher density within the lesion (n=1). Inhomogeneous iso- or hyperintensity on T1WI and hypo- or isointensity on T2WI without contrast enhancement were demonstrated. X-ray and CT of osteoid osteoma (n=6) revealed oval nidus and hyperdense spots within the nidus (n=5). X-ray and CT of osteoblastoma (n=1) showed a round lesion with clear and sclerosing border, and hyperdense spots were found within the lesion. Chondroma (n=17) included enchondroma (n=15) and ecchondroma (n=2). Sclerosing border at the medullary aspect (n=15) and cortical side (n=10) was demonstrated in enchondroma, but absent at cortical side in 5 cases. The cortex was discontinued and sclerosing border was absent on X-ray film for ecchondroma (n=2). Osteochondroma (n=7) originated from tubular bone (n=6) and flat bone (n=1). The growth direction of the tumor opposed the adjacent joints in tubular bone and protruded into the spinal canal as a lobulated mass in tabular bone (left lamina of vertebra at L3). Chondroblastoma (n=2) located at the proximal epiphysis of the tibia, presenting as a clear and sclerosing bordered oval and expanding lesion with bony destruction. Isointensity on T1WI and heterogeneous iso- or high signal on T2WI was revealed on MR imaging. X-ray, CT, and/or MR findings of ossifying fibroma (n=1), non

  18. 髋周良性骨病的影像诊断%Imaging Diagnosis of Benign Osteopathy around the Hip Joint

    Institute of Scientific and Technical Information of China (English)

    唐浩; 邹丹凤; 廖昕; 陈卫国

    2011-01-01

    目的 评价57例髋周良性骨病的影像学表现.方法 回顾性分析57例经穿刺活检或手术病理证实的髋周良性骨病的影像学表现.全部病例均行X线平片检查,32例同时行CT检查,21例行MRI检查.结果 骨囊肿13例,动脉瘤样骨囊肿16例,骨巨细胞瘤6例,软骨母细胞瘤2例(合并动脉瘤样骨囊肿1例),骨母细胞瘤1例,骨样骨瘤3例,骨化性纤维瘤2例,非骨化性纤维瘤3例,骨纤维异常增殖症6例,嗜酸性肉芽肿3例,骨结核2例.结论 髋周良性骨病以骨囊肿及动脉瘤样骨囊肿为好发病种.%Objective To evaluate imaging findings of benign osteopathy around the hip joint. Methods Fifty-seven cases with histologically confirmed benign osteopathy around the hip joint were reviewed. Radiography was performed in all cases,CT in 32 patients and MRI in 21 cases were done. Results There were simple bone cyst was in 13 cases,aneurysmal bone cyst in 16 cases,giant cell tumor in 6 cases,chondroblastoma in 2 cases (one case accompanied with aneurysmal bone cyst) osteoblastoma in 1 case,osteoid osteoma in 3 cases,ossifying fibroma in 2 cases, non-ossifying fibroma in 3 cases,fibrous dysplasia of bone in 6 cases, eosinophilic granuloma in 3 cases and bone tuberculosis in 2 cases. Conclusion Simple bone cyst and aneurysmal bone cyst are common benign osteopathy around the hip joint.

  19. Proton radiotherapy in management of pediatric base of skull tumors

    International Nuclear Information System (INIS)

    Purpose: Primary skull base tumors of the developing child are rare and present a formidable challenge to both surgeons and radiation oncologists. Gross total resection with negative margins is rarely achieved, and the risks of functional, structural, and cosmetic deficits limit the radiation dose using conventional radiation techniques. Twenty-nine children and adolescents treated with conformal proton radiotherapy (proton RT) were analyzed to assess treatment efficacy and safety. Methods and Materials: Between July 1992 and April 1999, 29 patients with mesenchymal tumors underwent fractionated proton (13 patients) or fractionated combined proton and photon (16 patients) irradiation. The age at treatment ranged from 1 to 19 years (median 12); 14 patients were male and 15 female. Tumors were grouped as malignant or benign. Twenty patients had malignant histologic findings, including chordoma (n=10), chondrosarcoma (n=3), rhabdomyosarcoma (n=4), and other sarcomas (n=3). Target doses ranged between 50.4 and 78.6 Gy/cobalt Gray equivalent (CGE), delivered at doses of 1.8-2.0 Gy/CGE per fraction. The benign histologic findings included giant cell tumors (n=6), angiofibromas (n=2), and chondroblastoma (n=1). RT doses for this group ranged from 45.0 to 71.8 Gy/CGE. Despite maximal surgical resection, 28 (97%) of 29 patients had gross disease at the time of proton RT. Follow-up after proton RT ranged from 13 to 92 months (mean 40). Results: Of the 20 patients with malignant tumors, 5 (25%) had local failure; 1 patient had failure in the surgical access route and 3 patients developed distant metastases. Seven patients had died of progressive disease at the time of analysis. Local tumor control was maintained in 6 (60%) of 10 patients with chordoma, 3 (100%) of 3 with chondrosarcoma, 4 (100%) of 4 with rhabdomyosarcoma, and 2 (66%) of 3 with other sarcomas. The actuarial 5-year local control and overall survival rate was 72% and 56%, respectively, and the overall survival

  20. Imaging diagnosis of benign osteopathy in proximal femur%股骨近端良性骨病的影像特征研究

    Institute of Scientific and Technical Information of China (English)

    程少容; 王鹰; 孙志强; 阳昱恒; 沈桂萍; 高松; 佘小夫

    2012-01-01

    Objective: To evaluate imaging findings of benign osteopathy in proximal femur and to optimize pre opera tive staging. Methods:56 cases of histologically confirmed benign osteopathy in proximal femur were involved. Radiogram of the hip joint was taken for all patients with additional examination of CT in 32 patients and MRI in 21 patients. Results: There were simple bone cyst in 15 cases,fibrous dysplasia in 11 cases,osteochondroma in 6 cases,aneurysmal bone cyst in 5 cases,giant cell tumor in 5 cases,chondroblastoma in 3 cases,osteoblastoma in 3 cases,ossifying fibroma in 2 cases,non os sifying fibroma in 1 case,benign fibrous histiocytoma in 1 case,enchondroma in 1 case,desmoplastic fibroma in 1 case,chon dromyxoid fibroma in 1 case and osteoid osteoma in 1 case. All these cases had common characteristics in terms of the lesion number,size,boundary,internal structure,soft tissue reaction and pathologic fracture. Conclusion:There are different kinds of benign osteopathy in proximal femur. Simple bone cyst and fibrous dysplasia are more frequently seen. JVIore than one lm aging methods used in combination play an important role in the diagnosis and differential diagnosis, and will be conducive to the choice of treatment and evaluation of prognosis.%目的:分析股骨近端良性骨肿瘤与肿瘤样病变的影像学特征表现,探讨其临床意义.方法:回顾性分析56例经手术病理证实的股骨近端良性骨肿瘤和肿瘤样病变的影像学特征表现.全部病例均行X线检查,其中30例同时行CT检查,25例行MRI检查.结果:骨囊肿15例,骨纤维结构不良11例,骨软骨瘤6例,动脉瘤样骨囊肿5例,骨巨细胞瘤5例,软骨母细胞瘤和骨母细胞瘤各3例,骨化性纤维瘤2例,非骨化性纤维瘤1例,纤维组织细胞瘤1例,内生软骨瘤1例,韧带样纤维瘤1例,软骨粘液样纤维瘤1例,骨样骨瘤1例.所有病例在病变部位、数目、大小、边界、内部结构、软组织改变及病理性骨

  1. MR imaging of the hip

    International Nuclear Information System (INIS)

    abnormalities shown with MR arthrography. Only the accurate detection of these lesions may allow early therapeutic intervention and, therefore relief of pain, and prevent or delay the development of arthritis. Avascular necrosis (AVN) also known as (ischemic) osteonecrosis, or aseptic osteonecrosis is a condition resulting from insufficient blood supply to the richly vascularized subchondral bone. AVN may be idiopathic, but is often secondary to trauma, exogenous steroid use or Cushing syndrome, alcoholism, pancreatitis, HIV, Gaucher, rheumatoid arthritis, Caisson's disease, etc. Symptoms are very much dependent on subchondral location. On T1-weighted images a low signal intensity line of demarcation is seen in over 90% of cases. On T2-weighted sequences a high signal intensity line appears within the low signal intensity in the majority of cases. This is referred to as the double line sign. This highly specific sign for AVN is secondary to a combination of factors including chemical shift artifact, presence of granulation tissue and sclerosis. The double line sign may be absent in early AVN. The signal intensity of the central zone may look like fat (early AVN), blood (rare), edema (not specific), or fibrotic tissue (advanced AVN). Marrow edema can also be seen in transient osteoporosis, osteomyelitis, and secondary to occult (subchondral) fractures or tumors like osteoid osteoma, osteoblastoma and chondroblastoma. The relationship between transient osteoporosis and AVN is controversial. Patients with edema without initial demarcation that develop AVN have subchondral abnormalities in the initial phase. Not rarely avascular necrosis is bilateral. The size of the necrotic area is the most important prognostic factor. When the necrotic volume is small, patients often are asymptomatic and collapse or fractures are uncommon. MRI is the most sensitive imaging modality in the early detection of AVN. The reported MR sensitivities of 85-97 % are superior to those of bone scintigraphy

  2. 160例成人朗格汉斯细胞组织细胞增生症患者临床特征分析%A clinicopathological analysis of 160 cases of adult Langerhans cell histiocytosis

    Institute of Scientific and Technical Information of China (English)

    许霞; 聂秀; 熊文; 潘华雄; 王威亚; 杨群培; 廖殿英; 刘卫平

    2015-01-01

    ),gastrointestinal (2,0.9%),ear (2,0.9%),and thyroid (2,0.9%),adrenal gland (1,0.5%) and sublingual gland (1,0.5%).Of 160 cases,150 (93.8%) had one organ involved while 10 (6.2%) had two or more organs involved.Clinically,77 cases (48.1%) were misdiagnosed as bone tumors (28 cases,including giant cell tumor,fibrous dysplasia,chondroblastoma,osteoblastoma and osteosarcoma),bone tuberculosis (13 cases),meningioma (9 cases),bone cysts (5 cases),chronic osteomyelitis (5 cases) and diabetes insipidus (5 cases),skin (4 cases) diseases malignant lymphoma (4 cases),chronic skin ulcers (4 cases),chronic otitis media (1 case),lung (1 case) and oral cancer (1 case).Conclusions In this group of the adult cases,the ratio of the male patients is higher.Adult LCH occurs predominantly in bone and presents mainly as unisystem single-focal disease,but multi-organ lesion and skin involvement are lower than that reported in the literatures.Just as LCH in children,adult LCH is also easy to be misdiagnosed.We should raise awareness of the disease and pathological examination is helpful for early diagnosis.