Chondrogenic Bone Tumors: The Importance of Imaging Characteristics

Hannes Engel; Georg W. Herget; Hannah Füllgraf; Reto Sutter; Matthias Benndorf; Fabian Bamberg; Pia M. Jungmann

doi:10.1055/a-1288-1209

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Inhaltsverzeichnis

Rofo 2021; 193(03): 262-275
DOI: 10.1055/a-1288-1209

Review

Chondrogene Knochentumoren: Bildgebung als Wegweiser?

Artikel in mehreren Sprachen: English | deutsch

Hannes Engel

¹Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

,

Georg W. Herget

²Department of Orthopaedics and Traumatology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

,

Hannah Füllgraf

³Institute for Surgical Pathology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

,

Reto Sutter

⁴Department of Radiology, Balgrist University Hospital, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Switzerland

,

Matthias Benndorf

¹Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

,

Fabian Bamberg

¹Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

,

Pia M. Jungmann

¹Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Germany

› Institutsangaben

Abstract

Zusammenfassung

Hintergrund Chondrogene Tumoren sind die häufigsten primären Knochentumoren. Maligne chondrogene Tumoren repräsentieren etwa ein Viertel der malignen Knochentumoren. Benigne chondrogene Knochentumoren sind häufige radiologische Zufallsbefunde. Radiologische Parameter können hilfreich sein zur Identifikation, Charakterisierung und Differenzialdiagnostik.

Methode Systematische Literaturrecherche mittels PubMed. Identifikation und kritische Beurteilung von Studien, welche die Bildgebung chondrogener Knochentumoren analysieren oder beschreiben.

Ergebnisse und Schlussfolgerung Nach der World-Health-Organization (WHO)-Klassifikation von 2020 werden benigne, intermediäre (lokal aggressiv oder selten metastasierend) und maligne chondrogene Tumoren unterschieden. Das typische radiologische Bild chondrogen differenzierter Tumoren ist gekennzeichnet durch ein lobuliertes Wachstumsmuster mit einem hohen Signal in T2-gewichteten Sequenzen in der Magnetresonanztomografie (MRT) und durch ein meist ring- und bogenförmiges Verkalkungsmuster in der Projektionsradiografie und der Computertomografie (CT). In Abhängigkeit der Entität ist dieses typische Muster unterschiedlich ausgeprägt. Während hochmaligne Tumoren häufig ein eindeutig malignes Wachstumsmuster zeigen, ist die Differenzierung zwischen benignen und intermediären chondrogenen Tumoren auch interdisziplinär schwierig.

Kernaussagen:

Die WHO unterscheidet gutartige, intermediäre und bösartige chondrogene Knochentumoren.
Häufige gutartige Tumoren: Osteochondrom und Enchondrom; häufiger bösartiger Tumor: konventionelles Chondrosarkom.
Differenzierung Enchondrom versus Low-grade-Chondrosarkom ist für Radiologen und Pathologen gleichermaßen schwierig.
Schmerzen, tiefes Scalloping, Kortikalisdestruktion, Knochenexpansion und Weichteilanteil sprechen für ein Chondrosarkom (versus Enchondrom).
Transformationshinweise beim Osteochondrom: Größenprogredienz nach Wachstumsabschluss, Knorpelkappendicke > 2 cm (Erwachsene) bzw. > 3 cm (Kinder).
Neuere, potenziell hilfreiche Bildgebungsmethoden: dynamisches MRT, Texturanalysen und FDG-PET/CT.

Zitierweise

Engel H, Herget GW, Füllgraf H et al. Chondrogenic Bone Tumors: The Importance of Imaging Characteristics. Fortschr Röntgenstr 2021; 193: 262 – 275

Key words

cartilage - neoplasms - chondroma - osteochondroma - chondrosarcoma - diagnostic imaging

Volltext

Referenzen

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