Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Has a sarcomatous connective tissue stroma with osteoid and bony tumor tissue arising from this malignant stroma. Classified as osteoblastic, chondroblastic, fibroblastic depending on the predominant tissue. Primarily metastasizes to the lungs but occasionally metastasizes to other bones. Is the most common primary skeletal malignancy in children. The tumor is eccentric, usually metaphyseal, but it may extend into the epiphysis or along the medullary cavity into the diaphysis. The long bones are involved in 80-90% of the cases. The most common sites in order of frequency are the distal femur, proximal tibia, proximal fibula, and proximal humerus. May also involve flat bones like the ileum and mandible.
On film see cortical bone destruction with lysis and sclerosis and an associated soft tissue mass with foci of calcification. Codman's triangle is the classic sign of malignant periosteal reaction.
MRI is best for establishing the medullary extent of the tumor.
Bone scan shows skeletal metastases best.
Chest CT is best at determining the presence of lung metastases.
See References Chapter.
Section Top | Title Page
Follow us on Twitter @pedseducation and @pedsimaging and Facebook @pedsimaging and Instagram @pedsimaging
Please send us comments by filling out our Comment Form.
All contents copyright © 1992-2016 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.
"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.
Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.
Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.
The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.