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located in multiple bones


An extremely aggressive sarcoma which typically presents with multifocal lesions in an anatomic region. This tumor may arise in association with a bone infarct or Paget's disease. High grade angiosarcoma seems to have two distinct clinical presentations. First, the lesion can present as multiple lesions in a single bone, two or more adjacent bones, or perhaps all the bones of a limb. These lesions seem to have an indolent course and the prognosis remains good. The second presentation is that of single or multiple rapidly progressive lesions that metastasize to other bones or to the lung this form of the disease has a very poor prognosis. This case illustrated the later type.

Patients present with increasingly severe bone pain. The radiographs shown here are of a 35 year old recently married auto mechanic whose wife had just had their first baby. He presented with severe pain in the distal femur. The initial work-up revealed multiple lesions in both lower extremities, including a lesion in the mid-diaphysis of the ipsilateral tibia and two lesions in the contralateral femur. A CT scan of the chest showed pulmonary nodules. Biopsy showed high-grade angiosarcoma of bone. Multiple, lytic, aggressive appearing lesions in a bone or adjacent bones.
Wide surgical resection and ajuvant therapy.

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Angiosarcoma de Hueso

Este es un tipo de sarcoma extremadamente agresivo que típicamente se presenta con lesiones multifocales en una región anatomica. Este tumor puede surgir en asociación a infarto de hueso o la enfermedad de Paget.

Los pacientes presentan un dolor severo de tipo progresivo.Múltiples lesiones agresivas y de apariencia lítica aparecen en el hueso afectado así como en huesos adyacentes.
Resección quirúrgica amplia y terapia adyuvante son los métodos de tratamiento para este tumor.

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Benign Fibrous Histiocytoma

This tumor has been given the names benign fibrous hystiocytoma, fibrous histiocytoma, xanthofibroma, fibroxanthoma of bone, and primary xanthoma of bone. The author of this site prefes the name benign fibrous histiocytoma.
There is no defined age group for this tumor except that patients are generally older than those found with a non-ossifying fibroma.
Clinically, patients report pain from the lesion, often of months or years duration. Pain may be associated with pathological fracture. There may be some local tenderness, but no swelling or mass is seen, and there are no systemic symptoms. There is normally no impairment of the function of the nearby joint. Spinal lesions may cause neurologic defect by pressing on the spinal cord.It has a lytic, loculated appearance with prominent sclerosis of the edges of the lesion.
Treatment consists of careful and complete curettage and filling of the defect with graft material, bone cement, or other suitable bone void filler.

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Bone island

A solitary area of mature, lamellar bone located within another bone, usually within an area of cancellous bone.

Patients are generally asymptomatic. These lesions are typically incidental finding on x-ray or other imaging study made for an unrelated reason.Most are 1 - 2 mm is size, but some can be up to 1 -2 cm. or even more. The lesion is latent, and merges at its margin with the surrounding bone. May be multiple, as in osteopoikilosis.
No treatment is needed. After the diagnosis has been confirmed, the lesion can be observed without treatment.

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