Presentation
Pain in the ankle
Patient Data
A relatively well-defined lobulated eccentric lytic lesion with a narrow zone of transition is seen at the meta-epiphyseal regions of the neck and body regions of the right talus.
The lesion has a sclerotic rim and thin internal septations that give it a pseudotrabeculated appearance.
The lesion is oriented along the long axis of the talus - best seen on lateral x-ray.
The lesion is complicated by a pathological fracture, which is seen at the talar dome.
Longitudinally oriented, predominantly lytic, and slightly expansile lesion is seen along the long axis of the neck and body regions of the talus.
The lesion is lobulated with a surrounding sclerotic rim; subtle internal calcifications and internal septations are seen within the lesion, giving a pseudotrabeculated appearance.
A longitudinally-oriented metaepiphyseal lesion is noted with its long axis oriented along the talus neck and body regions.
The lesion is well-defined with hypointense sclerotic rim on all the sequences.
Lesion is predominantly hyperintense on T2 and PD images, and hypointense on T1 images. Internal hypointense septations/calcifications are noted within the lesion, giving a pseudotrabeculated appearance.
Post-contrast reveals both intense homogenous enhancement with peripheral nodular enhancing soft tissue components.
Case Discussion
Chondromyxoid fibromas are rare tumors of cartilaginous origin. The classic location is at the metaphyseal region of the proximal shaft of the tibia, with its long axis oriented along the longitudinal shaft of the long bone.
Other atypical sites include the bones of the foot and pelvic bones.
In this case, the lesion was oriented longitudinally along the long axis of the talus. It had a narrow zone of transition, perilesional sclerosis, internal septations on X-ray, and subtle calcifications on CT scan, giving a pseudotrabeculated appearance. On MRI, the classic peripheral nodular soft tissue pattern of enhancement was present.
A primary diagnosis of chondromyxoid fibroma was given, with differentials of chondroblastoma also considered.
Histopathological confirmation confirmed the lesion to be a chondromyxoid fibroma of the talus.
Unable to process the form. Check for errors and try again.