Osteofibrous dysplasia of the tibia

Case contributed by Ian Bickle
Diagnosis certain

Presentation

13 year old with a large bony swelling on the mid-shin.

Patient Data

Age: 13
Gender: Female
Lateral
Frontal
Lateral
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Expansile cortical based lucent lesion with a narrow zone of transition in the mid tibial diaphysis.

The anterior cortext is thinned, but not breeched.   Internal 'soap bubble'appearance to the lesion which extends into the medulla and has a sclerotic rim.

This study is a stack
Coronal
T1
This study is a stack
Sagittal
T1
This study is a stack
Axial
T1
This study is a stack
Sagittal
STIR
This study is a stack
Coronal
STIR
This study is a stack
Axial
STIR
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
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T1 intermediate, T2 high signal enhancing mass in the anterior aspect of the tibial diaphysis with cortical thinning and minor breech, that extends into the medullary cavity.

Photograph
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Open surgical biopsy undertaken and histology report provided.

Case Discussion

Osteofibrous dysplasia is a benign bone lesion typically identified in the lower extremities. The tibia is the most frequent site accounting for 90% of all case a predilection for the anterior tibial cortex, as in this case.

The chief differentials was adamantinoma and fibrous dysplasia.

Surgical biopsy was performed to give this histologically proven diagnosis.

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