Learning objectives
This poster will feature:
1. Differential diagnosis of benign and malignant tumours and tumour-like conditions of the sacrum
2. Highlight imaging features which help to characterise them.
Background
The sacrum is a site for various primary and secondary tumours. Metastatic lesions, multiple myeloma and lymphoma are more common than primary sacral tumours. Primary tumours of the sacrum are rare (5% of sacral tumours).
There are also conditions which may mimic sacral neoplasms, including infection, Paget’s disease, insufficiency fractures and radiation osteonecrosis which should be considered in the differential diagnosis.
Symptoms when present are similar regardless of the aetiology: pain or neurologic deficits.
Knowledge of the differential diagnosis of sacral tumours and their distinctive...
Findings and procedure details
Findings
The patient characteristics of the various sacral lesions Fig. 1, their typical location Fig. 2, pattern of local spread/extension Fig. 3, bone scan and specific features Fig. 4 are described.
A. Benign sacral tumours
Giant Cell tumour (GCT)
GCT of the spine, represent 3-8% of GCT, most affecting the sacrum. Most are benign.
Typically expansile, osteolytic lesions with a thin cortical rim; without sclerotic margin or matrix calcification Fig. 5. CT and MRI often demonstrate a large soft-tissue mass, frequently with cystic foci, and...
Conclusion
Tumours of the sacrum are rare and the differential diagnosis includes a wide spectrum of benign and malignant conditions.
Imaging findings can aid to better characterise some of these tumours and tumour-like conditions and guide appropriate further management.
Personal information and conflict of interest
M. A. Png; Singapore/SG - nothing to disclose
T. S. Howe; Singapore/SG - nothing to disclose
P. C. Mohan; Singapore/SG - nothing to disclose
J. S. B. Koh; Singapore/SG - nothing to disclose
L.-P. Chan; Singapore/SG - nothing to disclose
M. H. Tan; Singapore/SG - nothing to disclose
References
Thornton E et al (2012) Br J Radiol 85:279–286
Diel Jet al (2001) Radiographics 21:83–104
Rossleigh et al (1986) Scintigraphic Features of Primary Sacral Tumors. 27:627–631
Ong KOet al (2014) Pictorial Essay : Tumours and Pseudotumours of Sacrum. Can Assoc Radiol J
Murphey et al (1996) From the Archives of the AFIP: Primary Tumors of the Spine: Radiologic-Pathologic Correlation. Radiographics