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KMID : 1103720150730040240
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Journal of the Korean Society of Radiology
2015 Volume.73 No. 4 p.240 ~ p.248
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Bone Tumors with an Associated Pathologic Fracture: Differentiation between Benign and Malignant Status Using Radiologic Findings
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Bae Ji-Hyun
Lee In-Sook
Song You-Seon
Kim Jeung-Il
Cho Kil-Ho
Lee Sung-Moon
Lee Young-Hwan
Song Jong-Woon
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Abstract
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Purpose
To determine whether benign and malignant bone tumors with associated pathologic fractures can be differentiated using radiologic findings.
Materials and Methods
Seventy-eight patients (47 men and 31 women, age range: 1-93 years) with a bone tumor and an associated pathologic fracture from 2004 to 2013 constituted the retrospective study cohort. The tumor size, margin, and enhancement patterns; the presence of sclerotic margin, the peritumoral bone marrow, soft tissue edema, extra-osseous soft tissue mass, intratumoral cystic/hemorrhagic/necrotic regions, mineralization/sclerotic regions, periosteal reaction and its appearance; and cortical change and its appearance were evaluated on all images. Differences between the imaging characteristics of malignant and benign pathologic fractures were compared using Pearson's chi-square test and the 2-sample t-test.
Results
There were 22 benign and 56 malignant bone tumors. Some factors were found to significantly differentiate between benign and malignant tumors; specifically, ill-defined tumor margin, the presence of sclerotic tumor margin and an extra-osseous soft tissue mass, the absence of cystic/necrotic/hemorrhagic portions in a mass, the homogeneous enhancement pattern, and the presence of a displaced fracture and of underlying cortical change were suggestive of malignant pathologic fractures.
Conclusion
Some imaging findings were helpful for differentiating between benign and malignant pathologic fractures.
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KEYWORD
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Fractures, Spontaneous, Bone Neoplasm, Magnetic Resonance Imaging
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