Faculty Bibliography

Lesions that involve the cortex of the tibia are fairly common in radiology practice. However, the number of diseases that involve the tibial cortex is great, and it can be difficult to arrive at a limited differential diagnosis from radiographic findings. Categorization of lesions of the tibia into those that cause cortical destruction and those that cause cortical proliferation can help narrow the broad differential diagnosis. Lesions that cause cortical destruction include nonossifying fibroma, fibrous dysplasia, osteofibrous dysplasia, aneurysmal bone cyst, giant cell tumor, eosinophilic granuloma, Ewing sarcoma, neurofibromatosis, adamantinoma, osteoblastoma, chondromyxoid fibroma, hemangioendothelioma, renal cell metastatic disease, hemangioma, and hemangiopericytoma. Lesions that cause cortical proliferation include osteochondroma, stress fracture, osteoid osteoma, periosteal osteogenic sarcoma, diaphyseal dysplasia, venous stasis, cellulitis, chronic osteomyelitis, osteopathia striatum, and melorheostosis. Conventional radiography along with clinical and pathologic data can aid in diagnosis of the wide variety of disease processes that involve the tibial cortex.

Malignant metastasis to the breast, rare in adults, has occurred in children from hematologic malignancies and from neuroblastoma and rhabdomyosarcoma. We report a case of bilateral breast metastases in a 14-year-old girl with a prior nephrectomy for renal cell carcinoma; the breast masses were the first sign of recurrence

Aggressive fibromatosis (AF) is a benign, non-metastatic proliferation of fibroblasts in the musculoaponeurotic compartment that tend to infiltrate locally and recur after surgical resection. Wide local excision with adequate clear margins is the treatment of choice. Magnetic resonance imaging (MRI) and computed tomography (CT) are excellent in delineating the extent and depth of these lesions. Thus they play an important role in the surgical management of these patients. There are a few descriptions of the MRI characteristics of these lesions in children. Radiographically, our cases are typical of others described in the literature-hypointense on T1-weighted images and hyperintense on T2-weighted images