Bone Tumours and Benign Lytic Lesions

Factors aiding diagnosis| Benign lesions | Malignant tumours | Osteomyelitis

Non-ossifying fibroma
| Solitary bone cyst | Aneurysmal bone cyst
Enchondroma
| Haemangioma | Fibrous dysplasia | Giant cell tumour

Osteosarcoma | Ewing's sarcoma | Chondrosarcoma | Metastases | Multiple myeloma

(click on images to enlarge)

When interpreting whether an image is normal or abnormal, it is common to come across incidental lytic lesions, which, depending on their appearance, must be classified as either a normal variant, or something which warrants further investigation.

It is difficult to determine radiologically with plain film imaging if a lytic lesion is benign or malignant. It is more accurate to describe whether the process looks aggressive or non-aggressive. Some factors, as outlined below, help to determine whether a lesion looks aggressive or non-aggressive, and therefore the differential diagnosis.

It is important to remember, however, that some benign processes such as osteomyelitis, can mimic malignant tumours, and some malignant lesions, such as metastases or myeloma, can look benign.

Factors aiding in the diagnosis of bone tumours and benign lytic lesions:
Age of patient
Location within the bone
Size of lesion
Monostotic (one lesion) or polyostotic (multiple lesions)
Zone of transition from normal to abnormal bone
Reactive sclerosis
Pattern of bone destruction
Presence of visible tumour matrix
Host (bone) response
Periosteal reaction
Soft tissue involvement
BENIGN LYTIC LESIONS
Non-Ossifying Fibroma / Fibrous Cortical Defect
Simple / Solitary Bone Cyst
Aneurysmal Bone Cyst
Enchondroma
Haemangioma
Fibrous Dysplasia
Giant Cell Tumour
MALIGNANT BONE TUMOURS
Osteosarcoma
Ewing's sarcoma
Chondrosarcoma
Metastatic Disease
Multiple Myeloma
OSTEOMYELITIS

 

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