<![CDATA[Bone and Soft Tissue Neoplasms: Axial Lesions]]>https://www.bstneoplasms.com/s/spine-lesionshttps://substackcdn.com/image/fetch/$s_!LzdO!,w_256,c_limit,f_auto,q_auto:good,fl_progressive:steep/https%3A%2F%2Fbucketeer-e05bbc84-baa3-437e-9518-adb32be77984.s3.amazonaws.com%2Fpublic%2Fimages%2Fd6bd471b-f449-4994-a7ca-020df9f523ff_947x947.pngBone and Soft Tissue Neoplasms: Axial Lesionshttps://www.bstneoplasms.com/s/spine-lesionsSubstackFri, 01 May 2026 02:13:23 GMT<![CDATA[Case 60: The Pitfalls of Rib Uptake on PSMA PET]]>https://www.bstneoplasms.com/p/case60https://www.bstneoplasms.com/p/case60Sun, 05 Apr 2026 23:57:02 GMT

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Case:

63-years old with Ca prostate had uptake on PSMA in the left 3rd rib anteriorly and right 6th rib posteriorly. The CT does not show any lesion there (Fig. 1).

A repeat FDG PET done 2 weeks later shows no uptake in those areas and no morphologic rib lesion (Fig. 2).

This is a known pitfall with PSMA PET for some reason. Isolated benign rib uptake without disease.

One paper (Fig. 3) has these statistics - 52% of biopsy-negative lesions were in the rib and only 26% of all rib biopsies performed for metastatic cancer were positive in patients who had PSMA positive rib uptake.

Takeaway - isolated rib uptake on PSMA PET should be viewed with caution and should not be automatically assumed to be metastatic disease. These lesions should be worked up carefully assuming they are benign unless proven otherwise.

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]]><![CDATA[Case 59: Spina Ventosa is More than Just Dactylitis]]>https://www.bstneoplasms.com/p/case59https://www.bstneoplasms.com/p/case59Sat, 04 Apr 2026 02:53:56 GMT

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Case:

11-years old with sternal and neck swelling

MRI showed an expansile osteolytic lesion in the manubrium sternum.

There were also enlarged left supraclavicular and mediastinal nodes.

The patient was referred for a CT guided biopsy. On CT, the lesion had a “bone-in-bone” appearance.

The video describes the case, the “ballooned-out” manubrium, the concept of spina ventosa, pictures from the 18th century showing spina ventosa in different bones of the body including the craniofacial skeleton and images of different bones show spina ventosa.

In short, “spina ventosa”, though synonymous with tuberculous dactylitis in current times, can actually affect any bone in the body...phalanges and metacarpals and metatarsals are just the more commonly involved bones.

Full Video


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]]><![CDATA[COD 152 - Large Calcific-Ossific Rib Masses]]>https://www.bstneoplasms.com/p/cod152https://www.bstneoplasms.com/p/cod152Tue, 17 Feb 2026 14:18:40 GMT

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Case:

66-years old with old left Ca breast treated with surgery, chemo RT 25 years ago went for MRI shoulder, which showed rib lesions.

The video explains the case, and shows what those rib lesions were, related to the radiation given in 2000, superficially resembling “tumoral calcinosis” and “radiation sarcoma”.

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]]><![CDATA[COD 148 - A Rib Lesion with Uptake on PET]]>https://www.bstneoplasms.com/p/cod148https://www.bstneoplasms.com/p/cod148Thu, 22 Jan 2026 14:17:04 GMT

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Case:

44-years old with fever and a PET showing an osteolytic lesion with uptake in the left 7th rib.

The video describes the case and discusses the possibilities and arrives at a diagnosis.

Video

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]]><![CDATA[COD 145 - A Swollen Face and The Tincture of Time]]>https://www.bstneoplasms.com/p/cod145https://www.bstneoplasms.com/p/cod145Sun, 11 Jan 2026 01:18:20 GMT

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Case:

3 months old in Jul 2023 with diffuse facial swelling due to mandibular periosteal reaction and masseter edema.

A diagnosis was made and the patient disappeared and came back yesterday for follow-up.

The video discusses the diagnosis and its relationship to chronic nonbacterial osteitis (CNO) which was discussed as Case 136.

Video

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]]><![CDATA[COD 140 - Spontaneous Epidural Hematoma Resolving Spontaneously ]]>https://www.bstneoplasms.com/p/cod140https://www.bstneoplasms.com/p/cod140Fri, 02 Jan 2026 01:03:57 GMT

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Case:

6-years old boy with acute upper thoracic pain and intermittent fever. MRI showed a posterior epidural collection from D3 to D6 extending into the right 3rd intercostal space.

The patient was referred for a biopsy.

The video explains what happened and discusses the diagnosis with another similar case in a 60-years old.

Video

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]]><![CDATA[COD 146 - The T2 Dark Retro-Odontoid Soft Tissue ]]>https://www.bstneoplasms.com/p/cod146https://www.bstneoplasms.com/p/cod146Thu, 25 Dec 2025 07:28:56 GMT

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Case:

91-years old referred for a CT guided biopsy.

MRI showed a T2 dark retro-odontoid soft tissue lesion.

Was this infection? Tuberculosis? Pannus? Neoplasm? Pseudotumor?

The video describes the case, the diagnosis, the etiology and 3 other cases

Video

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]]><![CDATA[Case of the Day 111 - Diffuse Marrow Change - Red Marrow or Diseased Marrow?]]>https://www.bstneoplasms.com/p/cod111https://www.bstneoplasms.com/p/cod111Thu, 02 Oct 2025 14:26:20 GMT

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Case:

13-yrs old treated in the past for left femoral osteosarcoma.

Whole body MRI shows diffuse marrow change. Is this red marrow proliferation as reported or is this diseased marrow? How do you tell?

The video discusses the case and a recent article that helps resolve this dilemma.

Video

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]]><![CDATA[Case of the Day 100 - 2025 09 10 - T2 Dark Thoracic Spinal Vertebral Lesion - Diagnosis?]]>https://www.bstneoplasms.com/p/cod100https://www.bstneoplasms.com/p/cod100Sun, 14 Sep 2025 00:16:21 GMT

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Case:

37-years old with radiating upper dorsal pain.

MRI showed a T2 dark lesion involving the D1 vertebral body and pedicle with crenated margins, without trabeculae.

The video discusses the case, the differentials, the final diagnosis with histopath images and one more similar case involving S1,

Video

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]]><![CDATA[Case of the Day - 085 - What the Mind Doesn't Seek, the Eye Won't See]]>https://www.bstneoplasms.com/p/case-of-the-day-085-what-the-mindhttps://www.bstneoplasms.com/p/case-of-the-day-085-what-the-mindWed, 13 Aug 2025 01:20:42 GMT10-yrs old with right scapular pain for 3 months, no fever.

MRI showed marrow and periosseous edema, centered around D1 on the right and was sent for a CT guided biopsy.

The video discusses the case and diagnosis and the concept of "you can't find what you're not looking for", which is the reason this diagnosis is missed again and again.

Video

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]]><![CDATA[Case 54: Multiple Bone Lesions]]>https://www.bstneoplasms.com/p/case54https://www.bstneoplasms.com/p/case54Sat, 14 Jun 2025 12:30:54 GMT

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Case:

A 41-years old presented with fever.

The initial chest CT showed multiple vertebral osteolytic lesions.

These were new compared to a CT scan done 7 months prior. No MRI was done.

PET/CT showed uptake along with multiple pelvic bone lesions

What do you think is the diagnosis?

The answer is up.

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Case of the Day Series

]]><![CDATA[Case 52: The Dorsal Clue]]>https://www.bstneoplasms.com/p/case52https://www.bstneoplasms.com/p/case52Mon, 03 Mar 2025 00:46:04 GMT

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Case:

A 30-years old presented with dorso-lumbar pain and discomfort.

MRI
PET/CT

What do you think is the diagnosis?

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]]><![CDATA[Case 50: Lingering Diagnosis]]>https://www.bstneoplasms.com/p/case50https://www.bstneoplasms.com/p/case50Wed, 11 Dec 2024 00:27:36 GMT

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Case:

A 15-years old presented with pain in the left hip radiating to the knee. A final diagnosis was made 15 months later.

What do you think is the diagnosis?

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]]><![CDATA[Case 41: Sacral Signals]]>https://www.bstneoplasms.com/p/case41https://www.bstneoplasms.com/p/case41Sun, 10 Dec 2023 23:58:42 GMTIndex & Table of Contents

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Case:

This 51-years old presented with erratic coccygeal pain. The MRI showed these findings.

The patient’s symptoms and MRI did not match. A PET/CT was then done for further work-up.

What do you think is the diagnosis?

Please see the video for the answer and a short discussion.

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Other Cases and Sites

New Book - Atmasvasth - Available on Amazon

https://www.amazon.in/dp/9359967521

]]><![CDATA[Case 38: Holes in the Hip]]>https://www.bstneoplasms.com/p/case38https://www.bstneoplasms.com/p/case38Mon, 31 Jul 2023 12:38:58 GMT

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Today’s New Case

This 51-years old presented with gradually progressive pain in the left hip for 3 months.

What do you think this is?

The answer is finally up. The video below discusses the case and other similar cases.

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Other Sites and Cases

https://www.ctchestreview.com/case87/

]]><![CDATA[Case 37: A Sclerotic Hemipelvis]]>https://www.bstneoplasms.com/p/case37https://www.bstneoplasms.com/p/case37Sun, 02 Jul 2023 00:38:49 GMTIndex and Table of Contents

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Today’s New Case

This 76-years old lady had been treated for carcinoma breast 15 years ago. She presented with mild pain in the right iliac crest region, for which she underwent a radiograph of the pelvis.

X-ray
X-ray

What do you think is the diagnosis?

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Other Sites and Cases

REF-Cafe Roentgen Thoracic Thursday Lecture Series

Lecture 1

Lecture 2

Lecture 3

]]><![CDATA[Case 35: The Iliac Overhang]]>https://www.bstneoplasms.com/p/case35https://www.bstneoplasms.com/p/case35Mon, 08 May 2023 00:17:33 GMTIndex and ToC

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20-years old presented with right hip pain.

X-ray
MRI
CT
Histopath

What do you think is the diagnosis?

The answer is up here.

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Last Week’s Case

Another Similar Site and Case

https://www.ctbiopsy.com/case123/

]]><![CDATA[Case 33: A Mushrooming Sacral Tumor]]>https://www.bstneoplasms.com/p/case33https://www.bstneoplasms.com/p/case33Sat, 25 Mar 2023 14:18:57 GMTThis 30-years old came with signs and symptoms of a sacral tumor.

The answer is up along with a discussion of the case, other similar cases and differentials.

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Last Fortnight’s Case

Bone and Soft Tissue Neoplasms
Case 32: A Cartilage Conundrum
Table of Contents…
Read more
3 years ago · Bhavin Jankharia

Check out the Table of Contents and Index

Bone and Soft Tissue Neoplasms
Index
Primary Bone Tumors Osteogenic Osteoid Osteoma Case 18: 23-years old with right arm pain - osteoid osteoma Osteoblastoma Case 19: 60-years old man with a talar lesion - osteoblastoma Osteosarcoma Case 3: 18-years old with knee pain - distal femur osteosarcoma…
Read more
4 years ago · 4 likes · Bhavin Jankharia

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Check this out

Running Safely On Indian Road - Run Facing the Traffic

]]><![CDATA[Case 17: A Left Iliac Osteolytic Lesion]]>https://www.bstneoplasms.com/p/case17https://www.bstneoplasms.com/p/case17Tue, 26 Apr 2022 14:03:47 GMT

If you would like to know each time a new case is up, not more than once a week

Here is the updated Table of Contents

Bone and Soft Tissue Neoplasms
Index
Primary Bone Tumors Osteogenic Osteosarcoma Case 3: 18-years old with knee pain - distal femur osteosarcoma Chondrogenic Chondroblastoma Case 6: 22-years old with shoulder pain - proximal humerus chondroblastoma Chondrosarcoma Case 15: 37-years old with shoulder pain - high grade chondrosarcoma…
Read more
4 years ago · Bhavin Jankharia

A 33-years old presented with acute onset left lower back pain after a session at the gym.

Simulated X-ray from CT scan
MRI
CT scan
Histopath

What is the most likely diagnosis?

  1. Giant cell tumor

  2. Plasmacytoma

  3. Aneurysmal bone cyst

  4. Metastasis

The answer is here.

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Next Week’s Quiz

Bone and Soft Tissue Neoplasms
Case 18: A Right Humeral Bump
The Updated Index and Table of ContentsIf you would like to know each time a new case is up A 23-years old came with pain in the right arm for a year with a hard bump anteriorly and laterally. What is the most likely diagnosis? Osteomyelitis Osteoid osteoma…
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4 years ago · Bhavin Jankharia

Last Week’s Quiz and Answer

Bone and Soft Tissue Neoplasms
Case 16: A Swollen Clavicle
If you would like to receive a new case in your email the moment it is published A 21-years old came with swelling of the clavicle for 3 months, with pain and tenderness, no fever and with two biopsies negative for tumor and granulomatous disease…
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4 years ago · Bhavin Jankharia

Other Cases

https://www.ctbiopsy.com/case89/

https://www.atmasvasth.com/fasting02/

https://www.ctchestreview.com

]]><![CDATA[Case 16: A Swollen Clavicle]]>https://www.bstneoplasms.com/p/case16https://www.bstneoplasms.com/p/case16Tue, 19 Apr 2022 01:21:56 GMT

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A 21-years old came with swelling of the clavicle for 3 months, with pain and tenderness, no fever and with two biopsies negative for tumor and granulomatous disease.

What is the most likely diagnosis?

  1. Ewing sarcoma

  2. Tuberculous osteomyelitis

  3. Langerhans cell histiocystosis

  4. Non-bacterial osteitis

The answer is here

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Next Week’s Quiz

Bone and Soft Tissue Neoplasms
Case 17: A Left Iliac Osteolytic Lesion
If you would like to know each time a new case is up, not more than once a week A 33-years old presented with acute onset left lower back pain after a session at the gym…
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4 years ago · Bhavin Jankharia

Last Week’s Answer

Bone and Soft Tissue Neoplasms
Case 15: A Proximal Humerus Lesion
To receive this in your email each time a new post is up A 37-years old presented with pain in the left shoulder…
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4 years ago · Bhavin Jankharia

The Updated Table of Contents

Bone and Soft Tissue Neoplasms
Index
Primary Bone Tumors Osteogenic Osteosarcoma Distal femur Chondrogenic Chondroblastoma Proximal humerus Fibrogenic Vascular Hemangioma Vertebral body Osteoclastic Giant-Cell Rich Giant Cell Tumor Distal femur Notochordal Other Mesenchymal Tumors Osteofibrous Dysplasia…
Read more
4 years ago · Bhavin Jankharia

Others

https://www.ctbiopsy.com/case88/

https://www.ctchestreview.com/case53/

https://www.atmasvasth.com/pa06/

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