The potential for pathologic fracture is a common problem associated with metastatic carcinoma or myeloma. These tumors often present as painful osteolytic lesions in the lower limb, with pain on…
An intracapsular margin is obtained when the surgical dissection extends through the reactive zone and the capsule or pseudocapsule into the tumor itself. A marginal margin describes a plane of…
Correct Placement of Incision. In any limb, a straight longitudinal incision is used. The biopsy incision is placed in the line of the planned subsequent resection (if malignant) so that…
Diagnostic Studies. MRI is the best imaging modality for both rhabdomyosarcoma and leiomyosarcoma. Treatment/Prognosis. Rhabdomyosarcomas occur primarily in children, and there has been a significant improvement in survival rates in…
Diagnostic Studies. Liposarcoma is best imaged by MRI and will have at least some fat with high signal intensity on T1-weighted images. Dedifferentiated liposarcomas will have a large area of…
Limb-salvage procedures (i.e., local excision) have replaced amputation as the primary treatment of soft tissue sarcomas; however, despite the efficacy of limb-salvage procedures in obtaining local control, pulmonary metastases remain…
Diagnostic Studies. Radiographs may also show calcification in areas of necrosis and metaplastic bone or cartilage inside lipomas. MRI reveals a homogenous fatty tumor that can be quite large. Treatment/Prognosis….
Diagnostic Studies. On MRI, tumor margins are sometimes difficult to distinguish from the normal fascial structures. Treatment/Prognosis. Treatment of desmoids has historically been by excision or resection, but based on…
Purely osteolytic metastases are generally from lung, kidney, thyroid, or colon cancer. Metastatic bone tumors from kidney or thyroid carcinoma are usually hypervascular, and preoperative embolization should be considered. Osteoblastic…
Diagnostic Studies. The radiographic appearance consists of multiple small, oval, radiolucent cortical defects with a distinct margin of reactive bone and a thickened cortex. Adamantinoma typically has a “soap bubble”…
