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Diagnosis of Primary Bone Tumors with Image-guided Percutaneous Biopsy: Experience with 110 Tumors¹

¹ From the Depts of Radiology (J.S.J.) and Pathology (B.M.S.), Washington Hospital Ctr, 110 Irving St NW, Washington, DC 20010; Dept of Orthopedic Oncology, Washington Cancer Institute, Washington Hospital Ctr, Washington, DC (J.S.J., J.A.W., R.M.H., M.M.M.); Dept of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC (M.D.M.); Dept of Radiology, Univ of Maryland Med Systems, Baltimore (M.D.M.); Dept of Radiology and Nuclear Med, Uniformed Services Univ of Health Sciences, Bethesda, Md (M.D.M.); Dept of Radiology, Mayo Clinic, Jacksonville, Fla (M.J.K.); and Dept of Orthopedic Surgery, George Washington Univ, Washington, DC (M.M.M.). From the 1999 RSNA scientific assembly. Received Jun 14, 2001; revision requested Aug 8; revision received Oct 1; accepted Nov 12. Address correspondence to J.S.J. (e-mail: JSJ2@medstar.net).

View larger version (111K): [in a new window]   Figure 1. Transverse CT image of the left shoulder obtained in a 16-year-old adolescent girl shows a small sclerotic osteosarcoma (arrow) of the proximal humerus. Note that attenuation of the lesion is equal to or greater than that of the adjacent bone cortex. Osteosarcoma was proved with biopsy results and was surgically resected.

View larger version (103K): [in a new window]   Figure 2. Transverse CT image of the upper pelvis obtained in a 16-year-old adolescent boy shows a nonsclerotic lytic lesion (*) of the left iliac bone, with predominant soft-tissue attenuation. There is involvement of the iliac bone and extension into the gluteal muscle (curved arrows) and into the iliac muscle (straight arrows). Ewing sarcoma was proved with biopsy results.

View larger version (105K): [in a new window]   Figure 3. Transverse contrast material-enhanced CT image of the middle of the pelvis obtained in a 45-year-old woman with a newly diagnosed 6-cm renal cell carcinoma and a mass in the right hip shows a cystic tumor. The CT scan shows a large cystic lesion of the right iliac bone, with multiple small hemorrhagic fluid levels (arrows). Initial percutaneous biopsy results showed nonspecific malignant cells. Frozen section analysis results at the time of surgery were also positive for malignancy but not diagnostic of osteosarcoma. Final pathologic evaluation after resection of the gross specimen showed telangiectatic osteosarcoma.