Skip to main content
SpringerLink
Log in

Radiologische Diagnostik maligner Tumoren des Muskuloskelettalsystems im Kindes- und Adoleszentenalter

Radiological diagnostics of malignant tumors of the musculoskeletal system in childhood and adolescence

  • Leitthema
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Das Rhabdomyosarkom, das Osteosarkom und das Ewing-Sarkom sind die am häufigsten auftretenden malignen Tumoren des Muskuloskelettalsystems im Kindes- und Adoleszentenalter. Diese Erkrankungen repräsentieren etwa 10% der bei Kindern und Jugendlichen neu diagnostizierten Tumoren.

In den letzten beiden Jahrzehnten hat sich insgesamt die Prognose der Patienten mit solchen Malignomen deutlich gebessert. Einerseits aufgrund der Fortschritte in der Chemotherapie und orthopädischen Tumorchirurgie, andererseits nicht zuletzt aufgrund der zahlreichen Innovationen der radiologischen Diagnostik. Das präzise prätherapeutische Staging von Tumoren des Muskuloskelettalsystems liefert wichtige prognostische Informationen und beeinflusst das gesamte Therapiemanagement. Während bzw. nach erfolgter Therapie ist die Bildgebung ganz entscheidend im Follow-up und bei der Diagnostik einer möglichen Rezidiverkrankung.

Die moderne bildgebende Diagnostik maligner muskuloskelettaler Tumoren umfasst im Wesentlichen das konventionelle Röntgen, die Computertomographie (CT) und Magnetresonanztomographie (MRT) sowie die nuklearmedizinischen Untersuchungen Szintigraphie, Positronenemissionstomographie (PET) und PET-CT.

Abstract

Rhabdomyosarcoma, osteosarcoma and Ewing’s sarcoma are the most common malignant tumors of the musculoskeletal system in childhood and adolescence representing about 10% of newly diagnosed cancers in children and adolescents.

In the last two decades the prognosis of patients with such malignancies improved significantly. On the one hand because of the advances in chemotherapy and orthopedic surgery, on the other hand also because of the innovations in radiological diagnostics. The precise pre-therapeutical staging of tumors of the musculoskeletal system provides important prognostic information and has impact on the entire therapy management. During respectively after therapy, imaging is extremely important in the follow-up and in diagnosing a possible recurrent disease.

Modern imaging diagnostics of musculoskeletal tumors basically consist of conventional X-ray, of computed tomography (CT) and magnetic resonance imaging (MRI), and of modalities of nuclear medicine such as szintigraphy, positron emission tomography (PET) and PET CT.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4

Literatur

  1. Anton CG (2005) Section 6: Musculoskeletal. In: Donnelly LF, Jones BV, O’Hara SM, Anton CG (eds) Diagnostic imaging pediatrics. Amirsys, Salt Lake City, Utah

  2. Arndt CA, Crist WM (1999) Common musculoskeletal tumors of childhood and adolescence. N Engl J Med 341: 342–352

    Article  PubMed  CAS  Google Scholar 

  3. Breitenseher M, Dominkus M, Amann G (2007) Bildgebende Diagnostik und Therapie der Weichteiltumoren. Thieme, Stuttgart New York

  4. Carrino JA, Khurana B, Ready JE et al. (2007) Magnetic resonance imaging-guided percutaneous biopsy of musculoskeletal lesions. J Bone Joint Surg [Am] 89: 2179–2187

    Google Scholar 

  5. Conway WF, DeSmet AA, Hayes CW et al. (1994) Musculoskeletal radiology. Radiology 190: 608–610

    PubMed  CAS  Google Scholar 

  6. Davies AM (1998) Imaging of primary osteosarcoma. Radiologe 38: 492–501

    Article  PubMed  CAS  Google Scholar 

  7. Dominkus M, Kainberger F, Lang S, Kotz R (1998) Primary malignant bone tumors. Clinical aspects and therapy. Vienna Bone Tumor Registry. Radiologe 38: 472–482

    Article  Google Scholar 

  8. Dominkus M, Krepler P, Schwameis E, Kotz R (2001) Diagnostic-therapeutic procedure in benign bone tumors. Radiologe 41: 583–589

    Article  PubMed  CAS  Google Scholar 

  9. Erlemann R (2001) Radiological diagnosis of bone tumors, 1. Radiologe 41: 930–943

    Article  PubMed  CAS  Google Scholar 

  10. Erlemann R (2001) Radiological diagnosis of bone tumors, 2. Radiologe 41: 1009–1023

    Article  PubMed  CAS  Google Scholar 

  11. Freyschmidt J (1998) Standards and diagnostic strategies in diagnosis of bone tumors and tumor-simulating lesions. Radiologe 38: 287–300

    Article  PubMed  CAS  Google Scholar 

  12. Freyschmidt J, Wiers J (1998) The staging of malignant bone tumors. Radiologe 38: 483–491

    Article  PubMed  CAS  Google Scholar 

  13. Funovics M, Philipp M, Breitenseher M (1999) Staging of musculoskeletal tumors in diagnostic imaging. Radiologe 39: 591–599

    Article  PubMed  CAS  Google Scholar 

  14. Hameed M (2007) Small round cell tumors of bone. Arch Pathol Lab Med 131: 192–204

    PubMed  Google Scholar 

  15. Henk CB, Grampp S, Wiesbauer P et al. (1998) Ewing sarcoma. Diagnostic imaging. Radiologe 38: 509–522

    Article  PubMed  CAS  Google Scholar 

  16. Iwamoto Y (2007) Diagnosis and treatment of Ewing’s sarcoma. Jpn J Clin Oncol 37: 79–89

    Article  PubMed  Google Scholar 

  17. Lodwick GS, Wilson AJ, Farrell C et al. (1980) Estimating rate of growth in bone lesions: observer performance and error. Radiology 134: 585–590

    PubMed  CAS  Google Scholar 

  18. Love C, Din AS, Tomas MB et al. (2003) Radionuclide bone imaging: an illustrative review. Radiographics 23: 341–358

    Article  PubMed  Google Scholar 

  19. McCarville MB, Spunt SL, Pappo AS (2001) Rhabdomyosarcoma in pediatric patients: the good, the bad, and the unusual. AJR Am J Roentgenol 176: 1563–1569

    PubMed  CAS  Google Scholar 

  20. Panicek DM, Gatsonis C, Rosenthal DI et al. (1997) CT and MR imaging in the local staging of primary malignant musculoskeletal neoplasms: report of the Radiology Diagnostic Oncology Group. Radiology 202: 237–246

    PubMed  CAS  Google Scholar 

  21. Parham DM (2001) Pathologic classification of rhabdomyosarcomas and correlations with molecular studies. Mod Pathol 14: 506–514

    Article  PubMed  CAS  Google Scholar 

  22. Parham DM, Ellison DA (2006) Rhabdomyosarcomas in adults and children: an update. Arch Pathol Lab Med 130: 1454–1465

    PubMed  Google Scholar 

  23. Puri A, Shingade VU, Agarwal MG et al. (2006) CT-guided percutaneous core needle biopsy in deep seated musculoskeletal lesions: a prospective study of 128 cases. Skeletal Radiol 35: 138–143

    Article  PubMed  CAS  Google Scholar 

  24. Rechl H, Hof N, Gerdesmeier L (2001) Differential diagnosis of bone and soft tissue tumors by MRI. Orthopäde 30: 528–539

    Article  PubMed  CAS  Google Scholar 

  25. Salamipour H, Jimenez RM, Brec SL et al. (2005) Multidetector row CT in pediatric musculoskeletal imaging. Pediatr Radiol 35: 555–564

    Article  PubMed  Google Scholar 

  26. Schaser KD, Bail HJ, Haas NP, Melcher I (2002) Treatment concepts of benign bone tumors and tumor-like bone lesions. Chirurg 73: 1181–1190

    Article  PubMed  Google Scholar 

  27. Sirikulchayanonta V, Jaovisidha S (2005) Soft tissue telangiectatic osteosarcoma in a young patient: imaging and immunostains. Skeletal Radiol 34: 295–298

    Article  PubMed  Google Scholar 

  28. Tateishi U, Yamaguchi U, Seki K et al. (2007) Bone and soft-tissue sarcoma: preoperative staging with fluorine 18 fluorodeoxyglucose PET/CT and conventional imaging. Radiology 245: 839–847

    Article  PubMed  Google Scholar 

  29. Tomiyama N, Ikezoe J, Miyamoto M, Nakahara K (1994) CT halo sign in metastasis of osteosarcoma. AJR Am J Roentgenol 162: 468

    PubMed  CAS  Google Scholar 

  30. Vilanova JC, Woertler K, Narváez JA et al. (2007) Soft-tissue tumors update: MR imaging features according to the WHO classification. Eur Radiol 17: 125–138

    Article  PubMed  Google Scholar 

  31. Völker T, Denecke T, Steffen I et al. (2007) Positron emission tomography for staging of pediatric sarcoma patients: results of a prospective multicenter trial. J Clin Oncol 25: 5435–5441

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinische Abteilung für Neuroradiologie und muskuloskelettale Radiologie, Medizinische Universität Wien , Währinger Gürtel 18-20, A-1090, Wien, Österreich

    S.F. Nemec & C.R. Krestan

  2. Klinische Abteilung für allgemeine Radiologie und Kinderradiologie, Medizinische Universität Wien, Wien, Österreich

    A. Hojreh & M. Hörmann

Authors
  1. S.F. Nemec
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C.R. Krestan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Hojreh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Hörmann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S.F. Nemec.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nemec, S., Krestan, C., Hojreh, A. et al. Radiologische Diagnostik maligner Tumoren des Muskuloskelettalsystems im Kindes- und Adoleszentenalter. Radiologe 48, 962–968 (2008). https://doi.org/10.1007/s00117-008-1651-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-008-1651-8

Schlüsselwörter

Keywords

Search

Navigation