FRCR 2B Companion Bone tumors 1
Despite its somewhat atypical location in the fibula, the radiographic appearance and demographic are classic for Langerhans cell histiocytosis.
There are multiple features which connote that this is an aggressive lesion:
In the absence of signs or symptoms of infection to suggest osteomyelitis, the differential for an aggressive-appearing lesion in a child includes metastasis (e.g. neuroblastoma), blue round cell tumor, and primary osseous lymphoma.