Presentation
Left knee pain with a lytic lesion on plain radiograph.
Patient Data
unique well-circumscribed femoral distal epiphyseal-metaphyseal lesion centered on the physis of a mature skeleton
partial destruction and breach of the surrounding cortex with mild soft tissue extension
surrounding bone marrow edema
the distance from the articular surface is <2 mm
the lesion is completely solid with no cystic nor fluid-fluid levels suggesting aneurysmal bone cyst-like changes. The solid components exhibit intense enhancement
no joint effusion
no pathologic fracture
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incidental phase-encoded motion artifact due to the popliteal artery pulsations
CT confirms the cortical involvement
there is no aggressive periosteal reaction
Case Discussion
Features of a giant cell tumor of the distal femoral epiphysis with concerning features and risk factors for local recurrence (cortical involvement, soft tissue extension, and proximity to the articular surface).
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