Central versus eccentric lesions of long tubular bones

Abstract

O NE OF THE important features of some of the tumors or tumor-like lesions of bone is their location in bone in relation to the central axis. This is particularly true if the lesion is located in the long tubular bone, such as humerus, radius, femur, and tibia. For example, a simple bone cyst, enchondroma, or fibrous dysplasia are almost always centrally located. In contrast, aneurysmal bone cyst, chondromyxoid fibroma, and nonossifying fibroma, among others, have been observed to be characteristically eccentrically located lesions. Some lesions, by nature of their anatomic location, are always eccentric, eg, fibrous cortical defect, periosteal desmoid, periosteal chondroma, cortical osteoid osteoma, cortical stress fracture, and subperiosteal hematoma. Obviously, on scintigraphy, this central or eccentric location may be appreciated, thus helping to include or exclude specific lesions in the differential diagnosis.