Imaging Review of Skeletal Tumors of the Pelvis Malignant Tumors and Tumor Mimics
Figure 3
Ewing’s sarcoma. A 21-year-old male with advanced Ewing’s sarcoma. AP radiograph (a) of the pelvis reveals a vague mixed density abnormality diffusely involving the right ilium (circle). Note the asymmetry when compared to the normal left ilium. Incidental note is made of oral contrast in the bowel. CT scan (b) of the pelvis demonstrates permeative lesion of the right ilium (arrows) and an associated soft tissue mass (asterisk). Small multifocal lytic lesions in the sacrum and bilateral ilium are in keeping with metastasis. Axial T2 image (c) of the pelvis reveals a large exophytic soft tissue mass (asterisk) along the anterior and posterior borders of ilium. Note the predominance of a huge soft tissue mass when compared to the bone abnormality, characteristic of small round blue cell tumors. Marrow edema is noted in the affected right ilium and multiple T2 bright lesions (arrowheads) in the sacrum and right ilium represent metastasis.
