Presentation
Left knee joint swelling with pain and difficulty in walking.
Patient Data
There is a sclerotic bony lesion which is involving, epiphysis, metaphysis and proximal one-third of the left tibial shaft (cortex and medulla) with associated sunburst periosteal reaction and cortical breach. No definite fracture is seen. Large soft-tissue mass invading the muscles with patchy bone-formation and multiple fluid collections.
Evidence of joint space involvement is seen as well, however, rest of the adjacent bones are apparently within normal limits (without obvious destruction). Abundant vascular channels are seen around the involved segment.
Slices through chest (not shown) showed multiple soft tissue density nodular lesions - possible pulmonary metastases.
Case Discussion
The patient's age with current CT findings (left-sided proximal tibial destructive bony mass lesion with associated soft tissues involvement) are more in favor of osteosarcoma which has confirmed on histopathology result.
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