pre op images
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Bhavin Jankharia
Oct 8, 2012, 5:14:24 AM10/8/12
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It was never an osteoid osteoma to begin with.
It may have been a cartilage lesion, surface with bone involvement and this has progressed or changed in character. The patient needs a PET/CT to look for lesions elsewhere in the body, followed by a biopsy of the most active area.
Bhavin
On 08-Oct-2012, at 2:41 PM, Access Devices wrote:
Pre op images--
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ajay upadhyay
Oct 8, 2012, 10:51:21 AM10/8/12
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I do agree with Dr Bhavin?subperiosteal haemetoma/?ABC/?FCD Do CT scan take fnac/biopsy definately not OO at this age Do give us fup Tx Dr Ajay Upadhyay --- On Mon, 8/10/12, Bhavin Jankharia <bha...@jankharia.com> wrote: |
Govindaraj Jayaraj
Oct 8, 2012, 10:12:03 PM10/8/12
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Dear All,
This is definitely not an Osteoid osteoma.
Too well defined, no bone reactive sclerosis (?? age, clinical history) and confined to the outer cortical layer.
More likely to be a
1. Benign Fibrous Cortical defect (Non Ossifying Fibroma)
Nonossifying fibromas are generally first noted incidentally on imaging studies (eg, after trauma). They typically are radiolucent, single, < 2 cm in diameter, and have an oblong lucent appearance with a well-defined sclerotic border in the cortex. They can also be mutiloculated.
2. Adamantinoma (unusual presentation) starts as a lucent mid diaphyseal cortical lesion
Adamantinoma is a rare tumor with an indolent course that occurs most commonly in the tibia. It is locally aggressive, and local recurrences are described after resection. Pain is the most common symptom. Since the lesion is typically slow growing, the pain can be present for many years before the patient seeks medical attention. Microscopically, adamantinoma consists of islands of epithelial cells in a fibrous stroma. Nuclear atypia is minimal, and mitotic figures are rare. This tumor most often affects the tibial diaphysis and produces lytic lesions that can cause fractures. .
Adamantinoma is a rare tumor with an indolent course that occurs most commonly in the tibia. It is locally aggressive, and local recurrences are described after resection. Pain is the most common symptom. Since the lesion is typically slow growing, the pain can be present for many years before the patient seeks medical attention. Microscopically, adamantinoma consists of islands of epithelial cells in a fibrous stroma. Nuclear atypia is minimal, and mitotic figures are rare. This tumor most often affects the tibial diaphysis and produces lytic lesions that can cause fractures. .
I hope this helps.
Such lesions are difficult to localize for Surgical excision.
In these instances a localizing pin can be centred into the lesion under CT/ Fluoro guidance and a localized excision with min. morbidity can be achieved.
Regards to all members of the group !!
jayarajg
Dr.Jayaraj Govindaraj
Senior Consultant Radiologist,
Apollo Speciality Hospital,
Mount Road,Teynampet,
Chennai-600035.
Res: Old.no:10,New.no:19,
9th cross street,
Shastrinagar,Adyar,
Chennai-600020.
Hosp:(044)24331741,
Res : (044)24919874,
Mob: 9841014128,
Fax: 91 44 24363646.
Senior Consultant Radiologist,
Apollo Speciality Hospital,
Mount Road,Teynampet,
Chennai-600035.
Res: Old.no:10,New.no:19,
9th cross street,
Shastrinagar,Adyar,
Chennai-600020.
Hosp:(044)24331741,
Res : (044)24919874,
Mob: 9841014128,
Fax: 91 44 24363646.
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