occipital condyle is equivalent to the vertebral body
Anterior part of vertebra has 4 lesions commonly-
Hemangioma – very t2 bright/t1 bright
GCT- t2 dark without sclerosis or mineralization
Chordoma- intermediate or bright on t2 with mineral
Clear cell CS- very t2 bright with mineral and peripheral enh
This one is likely
Chordoma
lytic
mineralization
not very bright on t2
intense enh
OT-RADS IV- biopsy
the neurosurgeon said he’s going to perform a biopsy. I will inform the follow-up.
Answers below:
EG or other. It’s not too bright on T2 to favour a chondroid tumour.
Enchondroma/Low grade chondrosarcoma.
Tough one but I will go with low grade chondrosarc. Has the calcifications in it.
I would say tumor with cartilaginous matrix.
Can we differentiate on the basis of CT + RM between Chondroblastoma, enchondroma an low grade chondrosarcoma?
What would be the criteria in this case? The bone seems ballooned, but with the interruption of the bone cortex… I think it needs a HP exam.
Looks chondroid. I might call it a chondroid neoplasm of indeterminate malignant potential and biopsy it since there is a history of pain.
Eosinophilic granuloma is in the DDX for this young man.
Chordoma
Em ter., 13 de jun. de 2023 às 23:28, Ciro Duarte <cirombd> escreveu:
26M, pain
Osteolytic lesion, containing calcifications, with well-defined margins, located on the left occipital condyle, showing intense impregnation by the intravenous contrast substance on MRI.
What’s your diagnosis?
1. Chondroblastoma
2. Enchondroma
3.
Low grade chondrosarcoma
4. Eosinophilic granuloma
5. Other
