mixed litic and osteosclerosing tibial tumor – CT and MRI

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Hi, dear OCADERS,

Any idea about this tumor in a 14y old female?
Stationary in size in the last 6 month
Well defined, sclerosing margins, I would say OTRADS II, but I worry about
the intense heterogeneity inside.
And also there is sort of a lipomatous halo around the tumor visible in T1
and T2 which puzzles me.

Thank you!

[image: bd ct.jpg][image: bd mri.jpg]

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3 thoughts on “mixed litic and osteosclerosing tibial tumor – CT and MRI”

  1. OCAD
    avneesh.chhabra

    OT-RADSIV
    biopsy
    edema-adc restriction

    Best!
    AC

    Avneesh Chhabra, M.D. M.B.A.
    Professor, Radiology & Orthopedic Surgery
    Chief, Musculoskeletal Radiology
    Department of Radiology
    5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
    Office: 214-648-2122
    http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>

    
    EXTERNAL MAIL

    Hi, dear OCADERS,

    Any idea about this tumor in a 14y old female?
    Stationary in size in the last 6 month
    Well defined, sclerosing margins, I would say OTRADS II, but I worry about the intense heterogeneity inside.
    And also there is sort of a lipomatous halo around the tumor visible in T1 and T2 which puzzles me.

    Thank you!


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  2. sorin.ghiea

    Hi everyone!

    It’s a bit late my response but:

    I received the following opinions, and thank you all for your time
    I decided to report as predominantly benign imaging characteristics, but I
    recommended biopsy.
    The patient and the orthopedist understood that even if it is benign, the
    treatment might be different between types of tumors.
    So…once I have the pathology report, I will notify you.

    Thanks again!!

    Sorin

    *1. Think fibrous dysplasia look at groundglass also in fibulaFD is very
    confusing non MRI2. osteofibrous dysplasiacan’t exclude osteofibrous
    dysplasia-like adamantinoma on imaging, though very unlikely.3 I would
    consider chondromyxoid fibroma.4. OT-RADSIVbiopsyedema-adc restriction5.
    ’ve seen examples of fibrous cortical defect with internal cystic change
    that later gets ossified 389590-overviewThe ADC restriction is worrisome.
    Please post any bx or followup results thanks6. Lipoma with cystic and
    sclerotic changes?*

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