Tumores óseos malignos: diagnóstico por imágenes
Resumen
Los tumores óseos malignos son una causa significativa de mortalidad y morbilidad; los primarios representan mayor morbilidad en niños y jóvenes; los secundarios, las metástasis, se dan en pacientes de mayor edad. La agresividad, la matriz y la localización del tumor asociados a la edad del paciente son fundamentales en el diagnóstico. La radiografía simple es la imagen inicial de mayor utilidad al sospechar un tumor óseo. Evaluar los márgenes de la lesión es el criterio radiográfico más importante en el análisis la agresividad. Factores adicionales que pueden orientar son la reacción periostal, compromiso de la cortical y la mineralización de la matriz. La Resonancia Magnética (RM) permite una mejor evaluación del compromiso de partes blandas. Los tumores malignos tienen características radiológicas diferentes entre ellos, los más frecuentes son el osteosarcoma, condrosarcoma, sarcoma de Ewing, tumor de células gigantes, fibrosarcoma, fibrohistiocitoma maligno, linfoma óseo primario, mieloma múltiple y metástasis. Existen lesiones similares a los tumores malignos, como las infecciones, que pueden confundir. Las imágenes siempre deben ser asociadas a la clínica, ya que ésta no solo tiene importancia en el diagnóstico, sino también en el pronóstico, con fin de pesquisar y derivar precozmente al paciente con sospecha de tumor maligno.Palabras clave:
Tumores óseos malignos, Diagnóstico por imágenesReferencias
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