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Incidental osteosarcoma during ultrasound

Case contributed by Gustavo Graco
Diagnosis certain

Presentation

Pain for weeks (undetermined) in the right leg.

Patient Data

Age: 35 years
Gender: Male

The fibula has an irregular bone cortex suggestive of aggressive periosteal reaction.

Expansive bone lesion arising from the mid diaphysis of the right fibula, with "sunburst" periosteal reaction, most in keeping with an aggressive neoplastic process.

Expansive lesion with aggressive characteristics in the middle third of the fibular diaphysis, infiltrating vascular structures and muscle groups.

Case Discussion

The patient attended the diagnostic imaging service, reporting pain in his right leg for weeks. The attending physician ordered a Doppler ultrasound exam, suspecting deep vein thrombosis. During ultrasound evaluation, periosteal reaction was observed. The patient underwent further investigation, revealing an expansive bone producing lesion with aggressive characteristics in the middle third of the fibular diaphysis. Histopathological analysis reported the diagnosis of osteosarcoma.

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