Hemangioma, Fibrosarcoma, Chordoma

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Category of hemangioma

Primary, blood, benign
2 types of hemangiomas
- Cavernous- MC
- Capillary- sunburst pattern
Most common structure in bone for hemangioma to occur

Cortex
Common sites for hemangiomas to occur
- Spine- thoracolumbar (MC benign bone tumor of spine)
- Skull- frontal
Common age to develop hemangiomas

Over 40, female bias
Is there pain associated with hemangiomas?

NO
Appearance of hemangiomas
- Vertical striations- vertebra
- Oval- skull
- Course trabeculation- seeing impact on trabecula
- Radiolucent- dark
- Geographic radiolucency in flat bone- hub & spoke appearance- starburst
Differential for hemangioma

Paget's disease- thickened end plates
Fibrosarcoma
- MOCEF
- #5 MC primary malignant bone tumor
Category of fibrosarcoma
- Primary
- Blood Malignant
2 types of fibrosarcoma
- Medullary (67%)
- Periosteal
MC structure in bone for fibrosarcoma to occur

BOTH
MC bone region for fibrosarcoma to occur

Metaphysis
Common sites for fibrosarcoma to occur
- Large tubular long bone- younger
- Femur- distal
- Tibia- proximal
- Humerus- proximal
- Flat bone- older
- Innominate
- Skull
Age for fibrosarcomas to occur

4th decade incidence- 31-40 yoa
Is there pain associated with fibrosarcoma
- Yes
- Local pain
- Swelling
- Fibrous mass- ONLY primary malignant tumor w/ sequestration
- Produces largest soft tissue mass
- Can spread to lymphatic system
- Pathologic fracture
Appearance of fibrosarcoma
- Geographic
- Soap bubble
- Highly destructive
- Permeative
- Fuzzy margin
- Expansile
- Lytic- radiolucent
- Cortical thinning
- Wide zone of transition
- Large soft tissue mass
Differential for fibrosarcoma
- Osteosarcoma- affinity to ossify
- Ewing's sarcoma
- Chondrosarcoma- affinity to calcify
- Giant cell- location
- Metastasis
- Plasmacytoma- age
Category of plasmacytoma
- Primary
- Blood
- Malignant
MC structure in bone for chordoma to occur?

Medullary
Common sites for chordomas to occur
- Ends of axial skeleton (85%)
- Sacrococcygeal
- Spheno-occipital- basion to foramen magnum, clivus
- MC vetebra- C2
- Can cross IVD
Age associated with chordomas
- B/w 40-70
- Males 2:1
Pain associated with chordomas
- Bladder/bowel dysfunction
- Increased intracranial pressure
- Ocular disturbances
- Motor weakness
- Sensory complaints
- Headaches
- Nasal discharge
- Breathing difficulties
Survival rate of chordoma

5 years- 8.7%
Appearance of chordomas
- Geographic
- Purely radiolucent- dark w/ no calcification speckles
- Centric
- Fluid filled cyst- serous fluid
- Pathologic fracture- due to slight bone expansion that weakens
- Fallen fragment sign- bone fragment from fracture that falls into cyst
- Endosteal scalloping
Differential for chordoma
- Aneurysmal bone cyst- painful
- Giant cell tumor

Author

nakomarose

30893

Card Set

Hemangioma, Fibrosarcoma, Chordoma

Description

Skel Rad B final

Updated

2010-08-23T15:13:05Z

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