Learning objectives
To review the specific anatomy of the acromion process and its ossification centres.
Present and review acromial tumours from a UK tertiary Orthopaedic oncology center.
Illustrate the key clinical and imaging findings of these acromial tumours,
which will provide a reference guide and a list of differentials for the radiologist.
Background
The acromion is an anteriorly projecting process arising from the lateral end of the spine of the scapula and supports the insertion of the deltoid muscle on the lateral and posterior aspects of the coraco-acromial ligament anteriorly.
It forms a synovial joint with the lateral end of the clavicle.
The acromion process itself has four ossification centers (pre-acromion (PRE),
meso-acromion (MESO),
meta-acromion (META) and basi-acromion (BASI) and in most cases full fusion will occur by the age of 18.
Malignant and benign acromial tumours are...
Imaging findings OR Procedure Details
Malignant lesions of the acromion process:
Chondrosarcoma
Chondrosarcomas are malignant tumours characterised by the formation of cartilage matrix and are the third most common primary malignant tumour of bone1.
In our review we identified chondrosarcoma to account for 21.9% of acromial lesions.
Chondrosarcoma of the acromion process can have a primary or secondary origin.
Numerous types of primary chondrosarcoma exist; intramedullary,
clear cell,
juxtacortical,
myxoid,
mesenchymal and extraskeletal.
Imaging findings directly reflect the pathological appearances as the different subtypes show distinctive features.
In the shoulder...
Conclusion
Acromial tumours are rare with a number of different malignant and benign lesions observed.
A high index of suspicion is needed for a timely diagnosis and management of tumours at this site.
The treatment of malignant or severely symptomatic acromial lesionswill depend on the confirmed diagnosis.
We have provided a radiological pictorial review of these cases with a guide for the radiologist when faced with an acromial lesion.
References
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