Osteoclastoma

Case contributed by Dr Baqar Hasan

Presentation

A 25-year-old man who presented with history of pain in the left knee for 3 to 4 months with no prior history of trauma or infection

Patient Data

Age: 25 yrs
Gender: Male
Modality: X-ray

Well circumscribed, expansile, sub articular, eccentric, solitary lytic lesion with a narrow zone of transition in the meta-diaphysis of proximal end of tibia. The lesion has characteristic soap bubble appearance with minimal marginal sclerosis. A cortical break is also seen of the anterior margin. Mild periosteal reaction along the lateral margin of the lesion is present. Overlying cortex appears thinned.

Modality: MRI

There is a fairly defined heterogeneously enhancing lesion in the proximal meta-diaphysis of the left tibia with predominant hypo-intense signals. The tibialis anterior muscle is displace laterally by the lesion. The lateral cortex overlying the lesion is not clearly demarcated. A heterogeneously hyperintense focus is seen projecting anteriorly, may represent the area of cortical break seen on lateral plain x-ray.

Case Discussion

Osteoclastoma, commonly known as giant cell tumor, probably arises from zone of intense osteoclastic activity. It comprises 4-9% of all primary bone tumours and 18-23% of benign bone tumours. Peak age of involvement is during the 3rd decade. It generally occurs after closure of epiphysis, which is a main differentiating point from aneurysmal bone cyst (ABC). It usually involves long bones, subarticular in location, eccentric with a soap bubble appearance. Periosteal reaction, narrow zone of transition, lack of soft tissue component involvement, narrow permeative zone and benign nature of the presentation allow the lesion to be differentiated from osteosarcoma. MRI plays an important role in the assessment of the lesion.
 

PlayAdd to Share

Case Information

rID: 27537
Case created: 6th Feb 2014
Last edited: 13th Mar 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.