Osteosarcoma - tibia

Case contributed by R Mannava
Diagnosis certain

Presentation

Right knee pain for several weeks. No inciting trauma.

Patient Data

Age: 15 years
Gender: Female
x-ray

Osteolytic lesion eccentrically located in the medial proximal tibial metaphysis with a wide zone of transition and cortical destruction. No periosteal reaction. No definite matrix mineralization.

mri

Heterogenous, T2 hyperintense, enhancing mass eccentrically centered in the proximal medial tibial metaphysis eroding the cortex and raising the periosteum.  Multiple additional satellite masses are in the nearby bone. The popliteus is edematous and enhancing.

Case Discussion

In a patient of this age with this apperance, the presumptive diagnosis is osteosarcoma.  Final pathology showed high grade osteosarcoma.

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