David W. Swenson MD, Presenter: Nothing to Disclose

Patricia Trinidad Chang MD, Abstract Co-Author: Nothing to Disclose

Kirsten Ecklund MD, Abstract Co-Author: Nothing to Disclose

Purpose: 1. Draw on examples of 90 pediatric patients who presented over the last 15 years, and who have both pre and post chemotherapy imaging of osteosarcoma, highlighting typical imaging features at diagnosis and in response to chemotherapy. 2. Demonstrate challenging cases of osteosarcoma presenting in unusual locations and with atypical imaging appearance. 3. Discuss the differential diagnosis for atypical osteosarcomas, and present examples of imaging mimickers in the axial and appendicular skeleton. 4. Review common conundrums of treatment response imaging, and present practical problem-solving tools.  

1. Osteosarcoma Basics a. Epidemiology b. Classic imaging 2. Osteosarcoma Imaging Evolution with Chemotherapy a. Increased osteoid production b. Intralesional hemorrhage c. Significance of increasing tumor size on therapy 3. Osteosarcoma Challenges a. Unusual locations, including skull, jaw, spine, and pelvis b. Atypical appearances in the appendicular skeleton c. Differentiating growth from treatment effects 4. Osteosarcoma Mimickers and Differentiating Findings a. Ewing’s sarcoma b. Langerhans cell histiocytosis c. Giant cell tumor d. Lymphoma e. Osteoblastoma f. Aneurysmal bone cyst g. Chronic osteomyelitis h. Phosphaturic mesenchymal tumor i. Post-traumatic lesions  

http://abstract.rsna.org/uploads/2014/14015306/14015306_5d1s.pdf

Swenson, D, Chang, P, Ecklund, K, Pediatric Bone Tumors: the Good, the Bad, and the Ugly . . . with Particular Attention to the Bad and Ugly.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015306.html