Primary tumors of spine are rare accounting for less than 5% of new bone tumors diagnosed every year. These tumors may exhibit characteristic imaging features that can help in early diagnosis and improved prognosis. Plasmacytoma/multiple myeloma and lymphoproliferative tumors are the most common malignant primary spinal tumors. Hemangioma is the most common benign tumor of the spine. Computed tomography is useful to assess tumor matrix and osseous change. Magnetic resonance is useful to study associated soft tissue extension, marrow infiltration, and intraspinal extension. Confusing one tumor with the other based on only imaging findings is not uncommon. However, radiologic manifestations of these tumors need to be correlated with the age, sex, location, and presentation to arrive at a close clinical diagnosis.

Giant-cell tumor (GCT) involving the skull base is rare. Sphenoid bone is the most commonly involved bone followed by petrous temporal bone. Histopathology and radiological features of these lesions are similar to GCT involving bone elsewhere. Unlike other sites, skull base is not an ideal site for the radical surgery. Hence adjuvant treatment has pivotal role. Radiation therapy with intensity-modulated radiation therapy, stereotactic radiosurgery or chemotherapy with adriamycin are promising as described in some case reports. Bisphosphonates showed good control in local recurrence. In vitro studies with Zolendronate loaded bone cement and phase 2 trials of Denosumab showed hopeful results, may be useful in future.

Background: Granulomas in bone marrow are an infrequent finding; however several diseases may be associated with granuloma formation and an etiologic diagnosis is essential. Bone marrow examination plays an important role in the diagnosis of various disorders associated with bone marrow granulomas and is useful in the investigation of pyrexia of unknown origin (PUO) as it leads to an etiological diagnosis in many of the cases. Aim: This study was undertaken to ascertain the frequency and etiological background of bone marrow granulomas. Material and methods: In the present study, forty seven cases with bone marrow granulomas were included. Clinical details, peripheral blood and marrow morphological findings were analyzed. Results: Pyrexia of unknown origin was the commonest presentation and anemia was noted in all cases. Twenty five cases had associated clinical conditions, including 7 with past history of tuberculosis and 8 with retroviral disease. Of the 47 cases, 7 showed granulomas in bone marrow aspiration, while bone marrow biopsy was diagnostic in all cases. Caseous necrosis was seen in 11(23.4%) cases. Acid fast bacilli were demonstrated in one bone marrow aspirate. Culture studies grew Brucella organisms in one case. Tuberculosis was the commonest in the present study as compared to other studies probably due to the endemicity of tuberculosis in this region. Conclusion: If the granuloma is associated with caseous necrosis and Langhan giant cells and correlated with clinical features, a possibility of the tuberculous etiology may be suggested to allow empirical treatment to be initiated before microbiological confirmation.

A left frontal intradiploic angioleiomyoma in a 10-year-old girl is presented with a review of the literature. The pathological and differential diagnosis and management of this rare lesion is discussed.

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