Presentation
Incidental finding on knee radiographs.
Patient Data
Intramedullary expansile lytic lesion of the proximal fibula with relatively well-defined margins and chondroid calcifications. No adjacent periosteal reaction is seen.
Moderately expansile lytic lesion (size = 3.5 cm) with mild endosteal scalloping containing chondroid calcifications (rings and arcs calcification) with no periosteal reaction or soft tissue component.
On the MRI exam, this lytic lesion demonstrates a low signal on T1, inhomogeneous high on PD fat sat and T2 with hypointense foci within the lesion representing rings and arcs calcification. The postcontrast sequences show enhancement of the scalloped margins with curvilinear translesional septa (rings and arcs enhancement). Evidence of endosteal scalloping. No gross bone destruction. No extraosseous spread or soft tissue component.
Case Discussion
The radiographic, CT and MRI features are most consistent with an enchondroma, however, it is important to be aware that enchondroma cannot be reliably distinguished from low-grade chondrosarcoma as they can have similar appearances.
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