Hemangioma, Fibrosarcoma, Chordoma

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Author:
nakomarose
ID:
30893
Filename:
Hemangioma, Fibrosarcoma, Chordoma
Updated:
2010-08-23 11:13:05
Tags:
Skel Rad
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Skel Rad B final
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  1. Category of hemangioma
    Primary, blood, benign
  2. 2 types of hemangiomas
    • Cavernous- MC
    • Capillary- sunburst pattern
  3. Most common structure in bone for hemangioma to occur
    Cortex
  4. Common sites for hemangiomas to occur
    • Spine- thoracolumbar (MC benign bone tumor of spine)
    • Skull- frontal
  5. Common age to develop hemangiomas
    Over 40, female bias
  6. Is there pain associated with hemangiomas?
    NO
  7. 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
  8. Differential for hemangioma
    Paget's disease- thickened end plates
  9. Fibrosarcoma
    • MOCEF
    • #5 MC primary malignant bone tumor
  10. Category of fibrosarcoma
    • Primary
    • Blood Malignant
  11. 2 types of fibrosarcoma
    • Medullary (67%)
    • Periosteal
  12. MC structure in bone for fibrosarcoma to occur
    BOTH
  13. MC bone region for fibrosarcoma to occur
    Metaphysis
  14. Common sites for fibrosarcoma to occur
    • Large tubular long bone- younger
    • Femur- distal
    • Tibia- proximal
    • Humerus- proximal
    • Flat bone- older
    • Innominate
    • Skull
  15. Age for fibrosarcomas to occur
    4th decade incidence- 31-40 yoa
  16. 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
  17. Appearance of fibrosarcoma
    • Geographic
    • Soap bubble
    • Highly destructive
    • Permeative
    • Fuzzy margin
    • Expansile
    • Lytic- radiolucent
    • Cortical thinning
    • Wide zone of transition
    • Large soft tissue mass
  18. Differential for fibrosarcoma
    • Osteosarcoma- affinity to ossify
    • Ewing's sarcoma
    • Chondrosarcoma- affinity to calcify
    • Giant cell- location
    • Metastasis
    • Plasmacytoma- age
  19. Category of plasmacytoma
    • Primary
    • Blood
    • Malignant
  20. MC structure in bone for chordoma to occur?
    Medullary
  21. 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
  22. Age associated with chordomas
    • B/w 40-70
    • Males 2:1
  23. Pain associated with chordomas
    • Bladder/bowel dysfunction
    • Increased intracranial pressure
    • Ocular disturbances
    • Motor weakness
    • Sensory complaints
    • Headaches
    • Nasal discharge
    • Breathing difficulties
  24. Survival rate of chordoma
    5 years- 8.7%
  25. 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
  26. Differential for chordoma
    • Aneurysmal bone cyst- painful
    • Giant cell tumor

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