Key result
CT and MR imaging of telangiectatic osteosarcoma typically demonstrate thick nodular tissue in a hemorrhagic lesion, with an associated soft-tissue mass seen in 76% of CT and 89% of MR cases.
Why the study?
What are the imaging characteristics of telangiectatic osteosarcoma that allow distinction from aneurysmal bone cyst?
Observational (n=40)
What are the imaging characteristics of telangiectatic osteosarcoma that allow distinction from aneurysmal bone cyst?
CT and MRI findings of thick nodular tissue and associated soft-tissue mass help distinguish telangiectatic osteosarcoma from aneurysmal bone cysts.
May help differentiate telangiectatic osteosarcoma from aneurysmal bone cyst on imaging; Level 5 evidence leaves open prospective validation.
PURPOSE: To describe the imaging characteristics of a large series of telangiectatic osteosarcomas with pathologic findings for comparison. MATERIALS AND METHODS: The authors retrospectively reviewed 40 pathologically confirmed telangiectatic osteosarcomas. Patient demographics and images from radiography (n = 36), bone scintigraphy (n = 17), angiography (n = 4), computed tomography (CT) (n = 25), and magnetic resonance (MR) imaging (n = 27) were evaluated by three authors in consensus for lesion location, size, and intrinsic characteristics. There were 27 men (68%) and 13 women (32%) in the study, with an age range of 4-83 years (mean age, 24 years). RESULTS: Lesions frequently affected the femur, tibia, and humerus. Radiographs showed geographic bone lysis, a wide zone of transition, and matrix mineralization. CT demonstrated low attenuation, MR demonstrated high signal intensity on T2-weighted images, and both demonstrated hemorrhage, which simulated the appearance of aneurysmal bone cyst. Viable sarcomatous tissue surrounding hemorrhagic and/or necrotic regions was best seen at contrast material-enhanced CT and MR imaging, with thick peripheral, septal, and nodular enhancement in all cases. Subtle matrix mineralization in this viable tissue was best seen at CT. An associated soft-tissue mass was also seen in 19 of 25 cases (76%) at CT and in 24 of 27 cases (89%) at MR imaging. CONCLUSION: CT and MR imaging findings of telangiectatic osteosarcoma often include thick nodular tissue (and matrix mineralization at CT) in a largely hemorrhagic and/or necrotic osseous lesion with an associated soft-tissue mass, which allows distinction from aneurysmal bone cyst.
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Murphey et al. (2003) conducted an observational in Telangiectatic osteosarcoma (n=40). Radiologic imaging was evaluated on Imaging characteristics. CT and MR imaging of telangiectatic osteosarcoma typically demonstrate thick nodular tissue in a hemorrhagic lesion, with an associated soft-tissue mass seen in 76% of CT and 89% of MR cases.
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