Skip to main content

Advertisement

Log in

Musculoskeletal tumours and tumour-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer

Part B: malignant mimics of benign tumours

  • Review Article
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

A wide range of musculoskeletal tumours and tumour-like conditions may be encountered when patients undergo radiological examinations. Some malignant musculoskeletal lesions may mimic benign tumours at imaging, being confused with benign cystic lesions or haematomas. Also, inappropriately selected magnetic resonance (MR) image sequences or computed tomography (CT) display windows can lead to misdiagnosis. Many orthopaedic surgeons interpret radiological images themselves, and therefore need to be as aware of these issues as radiologists are. This review describes and illustrates a number of such errors that commonly occur, and provides suggestions for avoiding these pitfalls.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Stacy GS, Dixon LB (2007) Pitfalls in MR image interpretation prompting referrals to an orthopedic oncology clinic. RadioGraphics 27:805–828

    Article  PubMed  Google Scholar 

  2. Ulaner G, Hwang S, Lefkowitz RA, Landa J, Panicek DM (in press) Musculoskeletal tumors and tumour-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer. PART A: benign conditions that may mimic malignancy. Int Orthop

  3. Wu JS, Hochman MG (2009) Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology 253:297–316

    Article  PubMed  Google Scholar 

  4. Sung M-S, Kang HS, Suh JS, Lee JH, Park JM, Kim JY, Lee HG (2000) Myxoid liposarcoma: appearance at MR imaging with histologic correlation. RadioGraphics 20:1007–1019

    PubMed  CAS  Google Scholar 

  5. May DA, Good RB, Smith DK, Parsons TW (1997) MR imaging of musculoskeletal tumors and tumor mimickers with intravenous gadolinium: experience with 242 patients. Skeletal Radiol 26:2–15

    Article  PubMed  CAS  Google Scholar 

  6. Yoo HJ, Hong SH, Choi J-Y, Moon KC, Kim H-S, Choi J-A, Kang HS (2009) Differentiating high-grade from low-grade chondrosarcoma with MR imaging. Eur Radiol 19:3008–3014

    Article  PubMed  Google Scholar 

  7. Huang H-Y, Lal P, Qin J, Antonescu CR (2004) Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Human Pathol 5:612–621

    Article  Google Scholar 

  8. Waters B, Panicek DM, Lefkowitz RA, Antonescu CR, Healey JH, Athanasian EA, Brennan MF (2007) Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. AJR 188:W193–W198

    Article  PubMed  Google Scholar 

  9. Kaya M, Wada T, Nagoya S, Sasaki M, Matsumura T, Yamaguchi T, Hasegawa T, Yamashita T (2008) MRI and histological evaluation of the infiltrative growth pattern of myxofibrosarcoma. Skeletal Radiol 37:1085–1090

    Article  PubMed  Google Scholar 

  10. Schwarzbach MH, Dimitrakopoulou-Strauss A, Mechtersheimer G, Hinz U, Willeke F, Cardona S, Attigah N, Strauss LG, Herfarth C, Lehnert T (2001) Assessment of soft tissue lesions suspicious for liposarcoma by F18-deoxyglucose (FDG) positron emission tomography (PET). Anticancer Res 21:3609–3614

    PubMed  CAS  Google Scholar 

  11. Rosen EL, Eubank WB, Mankoff DA (2007) FDG PET, PET/CT, and breast cancer imaging. Radiographics 27(Suppl 1):S215–S229

    Article  PubMed  Google Scholar 

  12. Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, Coleman RE, Wahl R, Paschold JC, Avril N, Einhorn LH, Suh WW, Samson D, Delbeke D, Gorman M, Shields AF (2008) Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med 49:480–508

    Article  PubMed  Google Scholar 

  13. Sonin AH, Pensy RA, Mulligan ME, Hatem S (2002) Grading articular cartilage of the knee using fast spin-echo proton density–weighted MR imaging without fat suppression. AJR Am J Roentgenol 179:1159–1166

    Article  PubMed  Google Scholar 

  14. Richardson ML, Amparo EG, Gillespy T 3rd, Helms CA, Demas BE, Genant HK (1985) Theoretical considerations for optimizing intensity differences between primary musculoskeletal tumors and normal tissue with spin-echo magnetic resonance imaging. Invest Radiol 20:492–497

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to David M. Panicek.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ulaner, G., Hwang, S., Landa, J. et al. Musculoskeletal tumours and tumour-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer. International Orthopaedics (SICOT) 37, 877–882 (2013). https://doi.org/10.1007/s00264-013-1824-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-013-1824-6

Keywords

Navigation