Presentation
Acute onset of right pelvic limb lameness while playing with a ball.
Patient Data
There is permeative osteolysis of the proximal third of the tibial diaphysis. There is a short zone of transition and mild irregular periosteal reaction. There is a short oblique fracture through the tibial diaphysis with several small associated fragments. There is mild medial and proximal displacement of the distal segment. A transverse fracture of the fibula is present at the same level.
Impression:
Primary bone tumor with pathologic fracture.
Case Discussion
Osteosarcoma with pathologic fracture was diagnosed on cytology after ultrasound guided fine needle aspirate. This is an unusual location for a primary bone tumor, being located in the diaphysis rather than in the more common location of the metastasis. The differential diagnoses then should include osteosarcoma as the most common primary bone tumor, as well as other primary bone tumors, a metastatic lesion, and osteomyelitis. The fibula likely fractured as a consequence of the tibial fracture.
Unable to process the form. Check for errors and try again.