“ Second most common primary bone tumour of children and adolescents (after osteosarcoma). It accounts for 10% of primary bone tumours, and ...
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Second most common primary bone tumour of children and adolescents (after osteosarcoma). It accounts for 10% of primary bone tumours, and 95% occur between 4 and 25 years of age (peak 10-15 years of age). Patients commonly present with a >6-month history of pain and swelling with or without fever.
PLAIN FILM
• 75% are found in the pelvis and long bones (if the spine is involved, it is usually the sacrum, 6% overall).
• Overall most common is the metadiaphyseal region of the femur.
• Permeative or moth-eaten osteolysis.
• Poor margination (wide zone of transition).
• Cortical erosion.
• Exuberant periostitis (lamellated or sunburst).
• Soft tissue mass.
MRI
• Marrow replacement, cortical destruction and soft tissue mass.
• Lesion is intermediate on T1 and high signal on T2 and there is diffuse or peripheral enhancement with contrast.
NUCLEAR MEDICINE
• Increased tracer uptake on scintigraphy, gallium scan and positron emission tomography (PET).
• PET/CT is highly sensitive (88%) for staging and restaging.
Ewing sarcoma. Frontal radiograph of the tibia/fibula demonstrating a lesion within the metadiaphyseal region of the
fibula with a permeative appearance, wide zone of transition and periostitis.
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