Benign Tumors
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| MC Benign tumor of the extremities | Osteochondroma
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| 50% of all benign bone tumors | Osteochondroma
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| MC age/gender of OSTEOCHONDROMA? | <20, male
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| Symptoms of an OSTEOCHONDROMA? | Painless, hard mass; stalk may fracture
Usually asymptomatic (often unreported)
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| If an OSTEOCHONDROMA becomes malignant what is it called? | Chondrosarcoma
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| What are the indications to remove an OSTEOCHONDROMA? | >5cm, painful
Cartilage cap should be <1cm...if >3cm at risk for chondrosarc
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| Where are OSTEOCHONDROMAS often found? | Metaphysis
Femur, humerus, tibia, pelvis, ribs, scap
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| What imaging findings will present with an OSTEOCHONDROMA? | SESSILE: Cartilage cap (uncommon) Lucent when en face (wide, broad metaphysis)
PEDUNCULATED (coat hanger or cauliflower like) - calcified cap; projects away from joint
Lucent when en face
Often found at LUSCHKA's TUBERCLE (on scap)
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| What % of HME transform into malignancy? | 5-25% to chondrosarc
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| What age to people present with HME? | 2-10yrs it is discovered
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| What symptoms will patients present with if they have HME? | Multiple painless osteochondromas, often bilateral
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| What are the MC locations of HME? | Knee, ankle, shoulder, wrist, MADELUNG'S DEFORMITY
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| What would HME appear like on radiograph? | "Brahma Bull" appearance on greater trochanter of femur (very wide metaphysis)
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| 2 types of hemangiomas? And locations for each? Which is the most common? | Cavernous [skull and spine- lower T, upper L] & Capillary [ribs, pelvis, long bones]
cavernous is MC 75%
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| What is the MC benign tumor of the spine? | HEMANGIOMA
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| Age/gender of patients with HEMANGIOMAS? | Female >40
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| Symptoms associated with HEMANGIOMAs | Asymptomatic; rare expansion causes neurological findings; paravertebral swelling
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| DDX for HEMANGIOMA type lesions? | Pagets, Osteoporosis, Hemangioma
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| What part of the spine is often affected by HEMANGIOMAs? | vertebral body (10-15% in arch)
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| Radiographic/MRI/CT findings for HEMANGIOMAs | Corduroy cloth; sand dollar (sunburst, spoke-wheel); polka dot appearance on CT
Paravertebral swelling
Bright on both T1 & T2 weighted images DT high fat content
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| ST Hemangioma is AKA? Where are they found? | Phleboliths; pelvic brim
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| Symptoms of an OSTEOMA? | Asymptomatic.
Will have blocked sinuses --> sinusitis
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| Diagnostic criteria for an OSTEOMA? | Hemartoma = normal cells in normal location just more of them
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| Common locations of OSTEOMAS | Sinus, mandible, skull, tibia
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| Radiographic finding of OSTEOMA | Osteosclerotic - arrises from surface of bone
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| What is the triad for GARDNER'S SYNDROME? | 1) Multiple osteomas; 2) Premalignant colon polyps; 3) Soft tissue fibromas
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| Another name for Bone Island? | Enostoma/Enostosis
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| ENOSTOMAS can be found in what age groups? and what are the symptoms? | any age, asymptomatic
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| Hemartoma can be associated with what two benign tumors? | osteoma & enostoma
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| Common locations for ENOSTOMAS? | Epiphysis & metaphysis; medullary space; pelvis (esp ilium); proximal femur.
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| Radiographic findings for Ensotomas? | Usually solitary round or oval radiodensity with RADIATING BRUSH BORDER. Occasionally warm on bone scan b/c can be growing.
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| Giant Bone Island measures what? | >2cm
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| DDX BI with Osteblastic Mets Pain # of Lesions Bone Scan Age Change in Size | BI: Pain = none; OM = yes
BI: # = Solitary; OM; multiple
BI: BS = can be warm; OM = hot
BI: Age = any; OM = >45
BI: Size chg = occasionally; OM = yes
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| Age/gender for OSTEOID OSTEOMA | 10-25 Male
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| Symptoms of OSTEOID OSTEOMA | Severe pain, worse at night (incr prostaglandins) relieved by aspirin. May get painful scoliosis if in spine.
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| What side of the scoliosis is OSTEOID OSTEOMA on? | Concave side
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| DDX for OSTEOID OSTEOMA-like tumor | 1) Brodie's Abscess 2) Osteoblastoma 3) Stress fx
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| MC Locations of OSTEOID OSTEOMAS | Metaphysis, Diaphysis; Femur & Tibia (50%); 10% spine (posterior elements)
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| Radiographic findings of an OSTEOID OSTEOMA | Central radiolucent nidus (<1cm); sclerotic border w/ central calcified fleck; solid periosteal bone reaction; cortical based – thickened. HOT bone scan (double density sign)
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| Preferred type of imaging to dx OSTEOID OSTEOMA? | CT
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| MC benign tumor of hand and foot? | Enchondroma
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