Tumoren der Wirbelsäule

Pitfalls in
the diagnosis of common benign bone tumours in children. Aneurysmal bone cyst of the second cervical vertebra (C2): a Lateral X-ray of the cervical spine: large expansile lytic lesion of the posterior arch C2 (between arrowheads). b CT, axial slice, bone windowing: confirmation of the lesion, with extreme thinning and focal interruption of the bone cortex. c CT, axial slice, soft-tissue windowing: fluid-fluid levels (arrows) are identified inside the cyst
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The differential diagnosis for a vertebral body mass is broad and may range from a completely benign, sclerotic enostosis (bone island) to a malignant primary bone tumor.

Classification

Broadly, these lesions can be separated into:

  • non-neoplastic lesions
  • primary bone tumors
  • secondary metastatic disease
Non-neoplastic lesions
Primary bone tumors

Primary bone tumors of the spine are much less common than secondary metastatic disease:

Secondary metastatic disease

Vertebral metastases are significantly more common than primary bone tumors, especially in an older patient or one with known primary disease elsewhere.

Assessment of whether the bone lesions are sclerotic or lytic may help to narrow the differential diagnosis of primary disease if it is unknown.

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