Imaging features of foot osteoid osteoma.

OBJECTIVES: We performed a retrospective review of the imaging of nine patients with a diagnosis of foot osteoid osteoma (OO). MATERIALS AND METHODS: Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) had been performed in all patients. Radiographic features evaluated were the identification of a nidus and cortical thickening. CT features noted were nidus location (affected bone-intramedullary, intracortical, subarticular) and nidus calcification. MRI features noted were the presence of an identifiable nidus, presence and grade of bone oedema and whether a joint effusion was identified. RESULTS: Of the nine patients, three were female and six male, with a mean age of 21 years (range 11-39 years). Classical symptoms of OO (night pain, relief with aspirin) were identified in five of eight (62.5%) cases (in one case, the medical records could not be retrieved). In five patients the lesion was located in the hindfoot (four calcaneus, one talus), while four were in the mid- or forefoot (two metatarsal and two phalangeal). Radiographs were normal in all patients with hindfoot OO. CT identified the nidus in all cases (89%) except one terminal phalanx lesion, while MRI demonstrated a nidus in six of nine cases (67%). The nidus was of predominantly intermediate signal intensity on T1-weighted (T1W) sequences, with intermediate to high signal intensity on T2-weighted (T2W) sequences. High-grade bone marrow oedema, limited to the affected bone and adjacent soft tissue oedema was identified in all cases. CONCLUSIONS: In a young patient with chronic hindfoot pain and a normal radiograph, MRI features suggestive of possible OO include extensive bone marrow oedema limited to one bone, with a possible nidus demonstrated in two-thirds of cases. The presence or absence of a nidus should be confirmed with high-resolution CT.

Metachronous myxofibrosarcoma and osteosarcoma: case report and review of the literature.

The occurrence of multiple primary sarcomas in one individual is very uncommon and the development of osteosarcoma as a second tumor following a soft tissue sarcoma is extremely rare. We report a case of a 62-year-old man who developed 2 histologically distinct sarcomas: a soft tissue myxofibrosarcoma and vertebral osteosarcoma. This unusual case highlights the critical role of careful histopathological evaluation in distinguishing synchronous or metachronous neoplasia from metastatic tumor. To the best of the authors' knowledge, this is the first reported case of metachronous soft tissue myxofibrosarcoma and osteosarcoma.