Clinical and Imaging Analysis of Primary Tumors of the Clavicle

Background: The clinical and imaging presentations of primary tumors and tumor-like lesions in the clavicle are not clear. Objectives: To investigate the clinical and imaging presentations of primary tumors and tumor-like lesions in the clavicle for better diagnosis. PatientsandMethods: Patientswithclaviculardiseasesbetween1963and2018confirmedbypathologywhohadplainradiography, computed tomography (CT) scan and magnetic resonance imaging were enrolled. The age, sex, imaging data, radiological signs and location of the tumor at the clavicle of patients were analyzed and compared. Results: Eighty-one patients with clavicular diseases were identified including 49 males and 32 females with an age range of 2 - 76 years (mean, 42.6). There were malignant tumors in 50 cases (61.7%), intermediate in 12 (14.8%), and benign in 19 cases (23.5%). Malignant tumors included metastatic tumors in 31 cases (38.3%), plasma-cell myeloma in ten (12.3%), and osteosarcoma in four (4.9%). The intermediate bone tumors were mainly eosinophilic granuloma in six cases (7.4%), and aneurysmal bone cyst in three (3.7%). Benign tumors were mainly osteochondroma (6.2%), bone cyst (3.7%), and chondroma (3.7%). Malignant tumors had bone destruction, periosteal reaction, ill-defined margins and soft tissue masses. Benign tumors and tumor-like lesions had well-defined margins. Conclusion: Many tumors may occur at the clavicle with more malignant than benign tumors with no specific imaging features in most lesions. A lesion near the sternal end with atypical benign imaging features should be considered as malignant.