EURORAD ESR

Case 9409

Osteosarcoma of the rib

Author(s)
Ip J, Conceição e Silva JP

Instituto Português de Oncologia de Lisboa, Francisco Gentil
Portugal
 
Patient
male, 6 year(s)
 
 
  • Figure 1
    Chest x-ray and Left-hand-side Chest-wall X-Ray

    Chest and Chest-wall x-rays at presentation, performed on July 2008 at emergency department outside of our Institution when the mother noticed a “lump” in the left-hand-side of the chest-wall.

     
    Area of Interest: Thoracic wall; Thorax; Imaging Technique: Conventional radiography;
     
     
  • Figure 2
    First CT

    First CT evaluation on July 2008, showed a bone lesion expanding to the inner and outer bounderies of the chest-wall with rib destruction. The limits were irregular and seemed to have some calcified matrix within.

     
    Area of Interest: Thoracic wall; Imaging Technique: CT;
     
     
  • Figure 3
    Second CT

    CT follow-up after 2 months of treatment showed no significant changes, therefore poor response to chemotherapy.

     
    Area of Interest: Thoracic wall; Imaging Technique: CT;
     
     
  • Figure 4
    MR evaluation

    Same time reported as 75 x 60 mm axial size with hypointense signal on T1-weighted images and inhomogeneous T2-weighted sequences as well as T2-SPIR. Apart from the compression vicinty organs were not involved.

     
    Area of Interest: Thoracic wall; Imaging Technique: MR;
     
     
  • Figure 5
    Chest X-Ray

    Chest X-ray prior to surgery confirmed the rib destruction and the calcium content within the lesion.

     
    Area of Interest: Thorax; Imaging Technique: Conventional radiography;
     
     
  • Figure 6
    Bone scintigraphy

    Focal osteoblastic lesion involving the 8th, 9th and 10th left ribs, with a predominance of the 9th arch.

     
    Area of Interest: Bones; Musculoskeletal system; Oncology;
     
     
  • Figure 7
    Positron Emission Tomography

    There is increased uptake of Fludeoxyglucose F18 (18F-FDG) at the base of the left hemithorax involving known rib and soft tissues contiguous, this lesion has a maximum SUV (standardized uptake volume) of 2.69.

     
    Area of Interest: Nuclear medicine; Oncology; Imaging Technique: PET;
     
     
  • Figure 8
    CT - Follow-up

    On follow-up CT, February 2010, few lung nodules were seen, and subsequent chemotherapy was programmed.

     
    Area of Interest: Thorax; Imaging Technique: CT;
     
     
  • Figure 9
    CT after chemotherapy - Follow-up

    On follow-up CT from January 2011, the patient was reported a complete response to treatment (surgery and chemotherapy).

     
    Area of Interest: Oncology; Thoracic wall; Thorax; Imaging Technique: CT;
     
     
  • Figure 10
    Chest X-Ray after treatment

    The last CXR from April 2011 showed chest wall deformity following surgery.

     
    Area of Interest: Thoracic wall; Thorax; Imaging Technique: Conventional radiography;
     
     
Chest and Chest-wall x-rays at presentation, performed on July 2008 at emergency department outside of our Institution when the mother noticed a “lump” in the left-hand-side of the chest-wall.
 
First CT evaluation on July 2008, showed a bone lesion expanding to the inner and outer bounderies of the chest-wall with rib destruction. The limits were irregular and seemed to have some calcified matrix within.
 
CT follow-up after 2 months of treatment showed no significant changes, therefore poor response to chemotherapy.
 
Same time reported as 75 x 60 mm axial size with hypointense signal on T1-weighted images and inhomogeneous T2-weighted sequences as well as T2-SPIR. Apart from the compression vicinty organs were not involved.
 
Chest X-ray prior to surgery confirmed the rib destruction and the calcium content within the lesion.
 
Focal osteoblastic lesion involving the 8th, 9th and 10th left ribs, with a predominance of the 9th arch.
 
There is increased uptake of Fludeoxyglucose F18 (18F-FDG) at the base of the left hemithorax involving known rib and soft tissues contiguous, this lesion has a maximum SUV (standardized uptake volume) of 2.69.
 
On follow-up CT, February 2010, few lung nodules were seen, and subsequent chemotherapy was programmed.
 
On follow-up CT from January 2011, the patient was reported a complete response to treatment (surgery and chemotherapy).
 
The last CXR from April 2011 showed chest wall deformity following surgery.
 
 
 
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