1. Bone Tumors

2. Most of them are highly malignant and affect children frequently.
Regional lymph nodes are rarely affected.
Bone neoplasms change or destroy the structure of the bone, and accordingly they show up as characteristic lesions in the radiographs.
As clinical features such as pain, swelling and discomfort are nonspecific, a long period of time
may elapse until the correct diagnosis is achieved.

3. Primary Bone Tumors
Metastatic Bone Disease

4. Primary Bone Tumors NON-MALIGNANT MALIGNANT Osteoid Osteoma
Osteoblastoma
Enchondroma
Periosteal Chondroma
Osteochondroma
Chondroblastoma
Chondromyxoid Fibroma
Giant Cell Tumor of Bone
Massive Osteolysis ( Gorham’s Disease)
Intraosseous Lipoma
Osteosarcoma
Chondrosarcoma
Ewing’s Sarcoma/Primitive
Neuroectodermal Tumor (PNET)
Lymphoma
Multiple Myeloma

5. Osteoid Osteoma
…uniquely painful benign lesions that most commonly occur during adolescence.
Males are af ected more commonly than females.
Most lesions occur in the meta- or diaphysis of the long bones (proximal femur and tibia) although, as with osteoblastoma, spinal lesions can lead to painful scoliosis.

6. Osteoid Osteoma

7. X-RAY

8. CT

11. Osteoblastoma Osteoblastoma is a rare benign bone tumor.
Patients often complain of intermittent episodes of pain. The clinical course is usually slow and indolent, but osteoblastomas can progress rapidly, mimicking a malignant process.
The usual age of onset is adolescence to early adulthood, but the clinical presentation is variable.
Males are affected more commonly than females.

12. CLINICAL SYMPTOMS Muscle atrophy or muscle spasm.
Spinal osteoblastomas occur in the posterior elements; muscle spasm in this area can lead to a painful scoliosis.

13. X-RAY
AP radiograph of the distal femur shows a purely lytic osteoblastoma in the epiphysis and metaphysis with mild osseous expansion but no evidence of sclerosis or mineral production

14. AP radiograph of the pelvis shows a densely sclerotic osteoblastoma in the left sacrum. Due to the extent of sclerosis, this lesion was initially mistaken for an osteosarcoma

15. X-RAY

17. Enchondroma
Enchondromas are relatively common benign intramedullary cartilaginous lesions that often are detected incidentally.
The peak age is the second decade. Half of enchondromas occur in the short tubular bones of the hands and feet followed by proximal humerus and proximal and distal femur.
Some enchondromas are painful and appear more aggressive radiographically but still display the bland, benign histology typical of asymptomatic lesions

18. Periosteal Chondroma
Periosteal chondromas are benign intracortical cartilaginous lesions.
Most patients are asymptomatic.
Lesions that become especially large may cause local mechanical
symptoms or bursitis.
Depending on the size of the lesion
and the patient’s body habitus, lesions may be palpated
on physical examination.
The majority of the patients
present within the second through the fourth decades of life

19. Periosteal chondroma of the proximal humerus. The lesion is
arising in the cortex of the proximal humeral metadiaphysis laterally. These lesions frequently result in a concave, scalloped deformity of the cortex with a sclerotic rim along the medullary side. Some lesions have an identii able shell of bone along the soft tissue margin. They may or may not have identii able calcii ed matrix mineralization

21. Osteochondroma
Osteochondromas are benign cartilage capped bony projections arising from the external surface of the bone that are ot en asymptomatic.
h ey may become painful due to compression of overlying structures or due to overlying bursa formation.
Sudden pain may be due to a fracture through the stalk. Most patients present in the i rst three decades.
Patients with multiple osteochondromatosis or with lesions close to physes frequently have developmental deformity.
h ere is a small (less than 1%) risk of transformation to a low-grade chondrosarcoma.
Lesions that continue to grow at er skeletal maturity and that have
cartilage caps greater than 1–2 cm should be examined carefully for malignant degeneration.

27. Giant Cell Tumor of Bone

28. Giant Cell Tumor of Bone

29. Osteosarcoma

30. Osteosarcoma

31. Osteosarcoma

32. Osteosarcoma

33. Osteosarcoma

34. Osteosarcoma

35. Ewing’s Sarcoma/Primitive Neuroectodermal Tumor (PNET)
Most patients present with local or regional pain from he lesion.
Swelling and a palpable mass may develop subsequently.
Most patients will have pain at rest or at night; signii cant mechanical or activity-related pain may herald pathologic fracture.
Many patients develop signs and symptoms of infection.
Lesions are ot en permeative with a broad zone of transition between the lesion and the surrounding bones.
Lesions typically present in the diaphysis or metadiayphisis of long bones, although l at bones such as the pelvis and scapula may also be involved.

36. Ewing’s Sarcoma/Primitive Neuroectodermal Tumor (PNET)

38. Ewing’s Sarcoma/Primitive Neuroectodermal Tumor (PNET)

39. Differential diagnosis of tumours
Non-malignant tumours
Malignant tumours
Pains absent or insignificant
Pain is intensive, especially nightly
Grow slowly
Grow quickly
Sometimes arrive at very largenesses
Large size arrive at rarely
Haven’t metastases
Early give metastases
Have opposition growth, wedge off surrounding fabrics, often limited a capsule
Have infiltration growth, a border with surrounding fabrics is not clear
Prognosis favourable
Prognosis doubtful

40. Metastatic Bone Disease

41. LUNG
BREAST
PROSTATE
KIDNEY
THYROID