E1305. Imaging of Bone Tumor Mimics: Pearls and Pitfalls
  1. William Wong; Vancouver General Hospital
  2. Peter Munk; Vancouver General Hospital
  3. Savvas Nicolaou; Vancouver General Hospital
  4. Nicolas Murray; Vancouver General Hospital
  5. Paul Mallinson; Vancouver General Hospital
  6. Adnan Sheikh; Vancouver General Hospital
  7. Hugue Ouellette; Vancouver General Hospital
Bone lesions are frequently encountered across the breadth of radiology examinations, and may be incidental or symptomatic. Often, the general radiologist may not be accustomed to managing them, especially in cases where they may mimic malignancy. Common pitfalls include excessive additional imaging, unnecessary biopsy of do-not-touch lesions, and failure to recognize malignant transformation. This educational exhibit will serve as a radiologist’s primer in the characterization and management of benign bone tumor mimics.

Educational Goals / Teaching Points
Review the imaging appearances of benign bone lesions which may mimic malignancy. Highlight specific features of these lesions which allow confident diagnosis. Juxtapose these features with imaging findings which should prompt further investigation. Discuss imaging pitfalls which may lead to incorrect management.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
This exhibit will discuss the imaging features of benign bone tumor mimics of the following categories: infectious/inflammatory, metabolic, cartilage-forming lesions, bone-forming lesions, fibrous lesions, and miscellaneous. Characteristic findings on radiographs, CT, and MRI will be reviewed, with a focus on features which will allow differentiation from malignant entities. Emphasis will also be put on common pitfalls in the imaging of these benign entities, including situations where they should not be intervened on, and in cases where complications have occurred.

Benign tumor mimics often present a diagnostic dilemma to the general radiologist. Appreciating specific features of these lesions, and understanding what features should raise alarm, are crucial in effective management.