Pathophysiology The histologic response to neoadjuvant chemotherapy is one of the most important prognostic factors for patients with bone or soft tissue sarcoma who are scheduled for surgical treatment. Patients whose tumors show little necrosis relative to the fraction of…
Staging encompasses determination of local tumor extent, including skip lesions, and identification or exclusion of distant metastases. Information on local extent and distant spread is a requisite for treatment planning, as discussed in Chapter 98 . Magnetic resonance (MR) is…
Surgical treatment of a patient with a musculoskeletal tumor is aimed against the disease but often also affects functional ability of the patient for the rest of his or her life. Disability related to treatment can be minimal in small,…
Etiology The formation of osseous metastases follows a complicated series of events that is dependent on the intrinsic properties of the cancerous cells that make up the primary malignancy. The process is regulated by multiple signaling pathways and molecular interactions.…
Every radiologist will occasionally be confronted with a mass of nonspecific imaging characteristics. Eventually, many of these lesions turn out to be non-neoplastic. These non-neoplastic masses belong to a large and heterogeneous group often named “pseudotumors.” Soft tissue pseudotumors are…
In this chapter a pragmatic or analytical approach is presented for the detection, staging, grading, and tissue-specific diagnosis of soft tissue tumors (STTs; Fig. 95-1 ). Because of the large number of types of these tumors, classification in a few…
There is a large spectrum of bone conditions that can have similar imaging appearances to tumors. These can be broadly classified into two categories. First are the space-occupying lesions in bone that are macroscopic in appearance but non-neoplastic in nature.…
Myeloma typically is a multifocal, or diffuse, disease that is also called Kahler's disease, multiple myeloma, myelomatosis, and plasma cell myeloma. Solitary myeloma (plasmacytoma) is rare and must be differentiated from an early manifestation of what will eventually appear to…
Primary bone tumors are rare and, unlike osseous metastases and myeloma, tend to occur in otherwise fit children, adolescents, and young adults. Patients typically present with either pain or swelling that may be initially mild or intermittent but, in time,…
When someone notices a soft tissue lump, it is inevitable that he or she will be worried and fearful until it can be identified. The patient may have discovered the lump, or it may have been felt or noticed by…