Malignant bone tumors

Differential Diagnosis

• Multiple myeloma
• Osteosarcoma
• Chondrosarcoma
• Ewing sarcoma

Name	Presentation	Radiograph Findings	Clinical Importance
Adamantinoma	Bone pain over anterior tibia in adolescent or young adult	Soap bubble osteolytic appearance on plain radiograph	Metastasis to lungs; may need amputation
Chordoma	Constant pain if in sacrum; neurological deficits if at base of skull, most commonly in cranial nerves to the eye	Plain radiograph will show a destructive bone lesion often with an associated soft tissue mass	Slow growing but locally aggressive; metastasis is uncommon, local recurrence is much more likely
Fibrosarcoma and Undifferentiated pleomorphic sarcoma	Similar to osteosarcoma except malignant fibroblasts but less common	Most common in distal femur and proximal tibia	Similar outcome to osteosarcoma
Primary bone lymphoma	Adult > 40 years of age with bone pain or pathologic fracture	Bone destruction; soft tissue mass	5 year survival is greater than 50% with radiation and chemotherapy