Presentation
Right hip pain and difficulty in walking.
Patient Data
X-ray shows a lytic expansile lesion in the right iliac bone.
Non-contrast CT also revealed a lytic expansile lesion in the right iliac bone.
A large expansile lytic lesion appearing heterogeneously hyperintense on T2/STIR and hypointense on T1 images measuring about 8.1 x 9.5 x 9.4 cm in maximum AP X TR X CC dimensions is seen involving the right iliac bone with patchy areas of diffusion restriction within.
T1 hyperintense areas are also seen along the superolateral aspect of the lesion likely hemorrhagic areas (probably post-biopsy). The lesion also has thin internal hypointensities within. Laterally, it extends into the gluteus muscles (minimus/medius) and medially into the iliacus muscles.
Case Discussion
This 45-year-old gentleman presented with complaints of progressive pain in the right hip region, increasing on walking. The patient was evaluated with an initial x-ray pelvis followed by CT and MRI. Imaging findings were consistent with chondrosarcoma. A biopsy was performed that revealed chondrosarcoma grade 2. The patient subsequently underwent a right hemipelvectomy.
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