Imaging Findings in Pseudocystic Osteosarcoma
Murali Sundaram1,
William G. Totty2,
Michael Kyriakos3,
Douglas J. McDonald4 and
Kurt Merkel5
1
Department of Radiology, St. Louis University Health Sciences Center, 3635
Vista at Grand, St. Louis, MO 63110-0250.
2
Mallinckrodt Institute of Radiology, Washington University School of Medicine,
510 S. Kingshighway, St. Louis, MO 63110.
3
Department of Surgical Pathology, Washington University School of Medicine,
St. Louis, MO 63110.
4
Department of Orthopedic Surgery, Washington University School of Medicine,
St. Louis, MO 63110.
5
Department of Orthopedic Surgery, St. Louis University Health Sciences Center,
St. Louis, MO 63110-0250.
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Fig. 1A. —Proximal tibial lesion in 7-year-old girl. Lateral radiograph
of proximal leg shows expansive osteolytic lesion of proximal metaphysis. Note
scalloping of anterior endosteal cortex.
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Fig. 1B. —Proximal tibial lesion in 7-year-old girl. Lateral radiograph
obtained 3 months after injection of steroids shows no change in metaphyseal
lesion.
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Fig. 1C. —Proximal tibial lesion in 7-year-old girl. Lateral radiograph
obtained 33 months after A and 36 months after B shows interval
growth of lesion. Note transverse fracture through middle of lesion. Minimal
callus bridges fracture line anteriorly, indicating that fracture is
subacute.
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Fig. 1D. —Proximal tibial lesion in 7-year-old girl. Contrast-enhanced
axial CT scan corresponding to C shows marked enhancement through
medial portion of lesion.
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Fig. 2A. —Tibial lesion in 3-year-old girl. Anteroposterior (A)
and lateral (B) radiographs of right leg, June1998, show well-defined
diametaphyseal osteolytic lesion of tibia with slight endosteal thinning.
Lesion is well marginated, and on lateral image, fracture is identified in
anterior cortex.
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Fig. 2B. —Tibial lesion in 3-year-old girl. Anteroposterior (A)
and lateral (B) radiographs of right leg, June1998, show well-defined
diametaphyseal osteolytic lesion of tibia with slight endosteal thinning.
Lesion is well marginated, and on lateral image, fracture is identified in
anterior cortex.
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Fig. 2C. —Tibial lesion in 30-year-old girl. Coronal (C) (TR/TE,
4500/96) and axial (D) (3500/119) MR images, 6 months after A
and B, confirm intracompartmental confines of tumor with aneurysmal
configuration.
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Fig. 2D. —Tibial lesion in 3-year-old girl. Coronal (C) (TR/TE,
4500/96) and axial (D) (3500/119) MR images, 6 months after A
and B, confirm intracompartmental confines of tumor with aneurysmal
configuration.
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Fig. 3A. —34-year-old woman with eccentric osteolytic lesion in left
femoral head and neck. Anteroposterior radiograph of left hip shows
intracompartmental osteolytic lesion eccentrically located in femoral head and
proximal neck and extending to intertrochanteric line.
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Fig. 3B. —34-year-old woman with eccentric osteolytic lesion in left
femoral head and neck. Frog lateral image confirms eccentric
intracompartmental lesion.
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Fig. 3C. —34-year-old woman with eccentric osteolytic lesion in left
femoral head and neck. Axial CT scan of left hip joint reveals thin shell of
bone containing lesion superolaterally without soft-tissue mass or
intraosseous matrix.
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Fig. 3D. —34-year-old woman with eccentric osteolytic lesion in left
femoral head and neck. T2-weighted MR axial image (TR/TE, 1950/90) shows no
extraosseous mass.
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Fig. 4A. —26-year-old woman with lesion in tarsal navicular bone.
Coned-down anteroposterior (A) and oblique (B) radiographs of
mid foot show multilocular osteolytic lesion expanding tarsal navicular bone
medially with intact cortex.
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Fig. 4B. —26-year-old woman with lesion in tarsal navicular bone.
Coned-down anteroposterior (A) and oblique (B) radiographs of
mid foot show multilocular osteolytic lesion expanding tarsal navicular bone
medially with intact cortex.
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Fig. 4C. —26-year-old woman with lesion in tarsal navicular bone.
T1-weighted coronal MR image (TR/TE, 500/17) shows complete replacement of
tarsal navicular bone by tumor.
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Fig. 4D. —26-year-old woman with lesion in tarsal navicular bone.
Fat-suppressed coronal MR image (4500/105) reveals no extraosseous mass. Tumor
has multilocular appearance with high signal intensity and fluid-fluid
levels.
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Copyright © 2001 by the American Roentgen Ray Society.
