Chondrosarcoma - phalanx

Case contributed by Dr Domenico Nicoletti

Presentation

Pain and swelling of the second toe of the right foot.

Patient Data

Age: 55 years
Gender: Male
X-ray

Right foot

An expansile exophytic osteolytic cortical lesion is noted projecting from the lateral cortex of the middle phalanx of the second finger of the right foot. Cortical erosion on the external side is associated with soft tissue infiltration where tiny calcifications are recognizable.

A lytic lesion is also present in the distal phalanx, on the second finger.

CT

Right foot

Parosteal osteolytic lesion on the external side of the middle and distal phalanx of the second toe, extended to the soft tissues, with fine intra and perilesional calcifications. In the middle and distal phalanges, there is a focal interruption of the cortex.

MRI

Right foot

Expansive neoformation of the second finger with cortical erosion of the middle and distal phalanges on the external side.

The lesion with tiny calcifications in the context is hypointense in T1 and hyperintense in the T2-weighted sequences, where thin septa that show enhancement after contrast.

Pathology

The histological report revealed grade I chondrosarcoma.

X-ray

Postoperative

Post-operative x-ray of the right foot after amputation of the second toe apart from the proximal segment of the proximal phalanx.

Case Discussion

The patient underwent surgery, and the pathology of the whole specimen came back as grade I chondrosarcoma.

Chondrosarcoma is a cartilaginous malignant tumor of the bone. It commonly occurs in the pelvis, proximal femur and scapular fascia.

The localization in the foot is rare where it can become difficult to distinguish chondrosarcoma from an enchondroma.

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Case information

rID: 69047
Published: 26th Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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