Chest Wall Mass in Infancy: The Presentation of Bone-Tumor-Like BCG Osteitis

Table 2

Comparison of clinical characteristics of bone tumors and osteomyelitis of the chest wall.

	Bone tumor	Osteomyelitis of chest wall
Cause	Malignant: Ewing sarcoma, Langerhans cell histiocytosis, osteosarcoma, primitive neuroectodermal tumor, metastatic neuroblastoma and leukema; Benign: fibrous dysplasia, enchondroma, osteochondroma, etc. [21]	Common: Staphylococcus aureus, Klebsiella pneumoniae; Rare: propionibacterium, mycobacterial species, salmonella, etc.
Median time to diagnosis	Vary among tumor behavior and pathology.	Median time 5.4 months (ranged 2 weeks to 1 years) [19]
Alkaline phosphatase (ALP)	Elevated or normal	Normal
C-reactive protein (CRP)	Normal	Elevated
WBC count	Normal	Rarely elevated
Plain radiologic finding	Osteosclerotic, lytic lesion depend on tumor type	Lytic lesion is more common than osteosclerosis [19]
Periosteal reaction	Lamellated periosteal reaction, radiating spicules (sunburst)	Lamellated periosteal reaction
Penumbra sign on T1W MRI	Rare	Occasional
Surgery	Resection is required in most	Biopsy is required in most; debridement is limited for refractory cases