Dedifferentiated liposarcoma with heterologous osteosarcoma component

YOUR LINK HERE:

http://youtube.com/watch?v=boZUcas_QIk

Dr. Ebraheim’s educational animated video describes miscellaneous tumors of the cervical spine. • Hemangioma: • •Hemangiomas are benign hamartomatous vascular lesions in the spine. • •Most hemangiomas are isolated lesions that affect a single vertebra. • •On x-ray, hemangiomas appear as abnormal thickened trabeculae with vertical striation (honeycomb appearance). • •Most are asymptomatic and present as incidental finding and do not require intervention. • •Preoperative embolization if resection is needed. • Osteoid osteoma and osteoblastoma: • •Osteoid osteoma and osteoblastoma are histologically similar to each other, however the osteoblastoma tends to grow larger than 2 cm. • •Osteoblastoma may sometimes displace characteristics that may be confused with osteosarcoma. • •Osteoblastoma – you will do marginal excision. • •Osteoid osteoma is almost impossible to visualize onx-ray due to its small size. • •The patient usually presents painful scoliosis or torticollis (pain is relieved with aspirin). • Aneurysmal bone cyst: • •Fluid level • oPain could be present • oTreatment is excision • •Expansile osteolytic lesion with a thin wall containing blood-filled cystic cavities that usually effect the posterior element of the spine. • Eosinophilic Granuloma • •Caused by histiocytosis X • •Usually seen in children under the age of 10 years old. • •It is a lytic lesion of the vertebral body that will show on x-ray as a dense ring of collapsed cortical bone sandwiched between intact vertebral discs (vertebral plana). • •It is rarely symptomatic and self-limiting. • •Conservative treatment with orthosis. • •Large tumor may compress the spinal cord and is usually treated by low dose radiation therapy. • Giant Cell Tumor • •It usually occurs in the sacral region of the spine and less commonly affects the cervical spine. • •It may be difficult to distinguish giant cell tumors from other tumors of the spine on x-rays. • •This tumor is usually found in the anterior column of the spine. • •On x-ray it will appear as a radiolucent expansile lesion with a cortical shell and a bony septa. • •Recurrence is common secondary to inadequate resection. • •10% incidence of malignant transformation due to irradiation. • Osteochondroma • •It is a cartilaginous growth on the surface of the bone. • •It usually arises from the posterior element (eg spinous processes). • •It may not be visible on x-rays. • •The radiolucent cap may grow and cause compressive symptoms. • •Excision if symptomatic. • •Malignant transformation to chondrosarcoma should be suspected if the cartilaginous cap is more than 2 cm in diameter. • Paget’s disease • •Paget’s disease is a chronic disorder that can result in enlarged bones. • •Excessive breakdown and formation of bone tissue which ends by sclerosis giving the ivory appearance on x-ray. • •Less likely to develop in the cervical spine and more common in the sacral and lumbar regions. • •Differential diagnosis for prostatic metastasis. • Osteosarcoma • •Osteosarcoma is rare in the spine. • •Malignant tumor is found to affect any level of the spine, although the lumbar and sacral regions are more common. • •On plane x-ray, osteosarcoma appears as lytic and blastic lesions with destruction of the vertebra and relative sparing of the adjacent discs. • Ewing’s Sarcoma • •It affects the body of the vertebra. • •Most commonly detected in patients between 10-20 years of age. • •Appears on x-rays as a lytic lesion with osseous expansion or sclerosis. • Multiple Myeloma • •It is the most common primary malignancy of the bones and spine. • •It is due to malignancy of the plasma cells. • •Appears on x-rays as lytic lesions of the bone (punched out lesions). • •Skeletal survey is used to screen for other lesions throughout the body. • •Bone scans have low sensitivity in detecting disseminated disease. • •Treatment is usually radiotherapy. Surgery is used for decompression and/or stabilization. • Lymphoma • •Mainly Non-Hodgkin’s lymphoma. • •Bone lymphoma is commonly diagnosed between 40-60 years of age. • •It can be detected on plane x-rays in only 30-42% of patients. • •Treatment is radiotherapy and chemotherapy. • Metastasis • •The most common tumor that metastasis in the spine are: • oProstate neoplasm • oBreast neoplasm • oLung neoplasm • oRenal neoplasm • oThyroid tumor • •Differential diagnosis – infection • oInfection usually affects the end plates • oTumor usually affects the body and the pedicles. • Become a friend on facebook: • / drebraheim • Follow me on twitter: • https://twitter.com/#!/DrEbraheim_UTMC • Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund: • https://www.utfoundation.org/foundati...

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