Reactive Mimics of Neoplastic Osseous Lesions- A Case Report.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 4
Abstract
Fracture healing is a proliferative physiological process that follows specific regenerative patterns and altered expressions of several thousand genes.However,sometimes this biological process fails and the lesions end up showing delayed healing,infections,malunion,pseudoarthrosis or non-union.Fracture callus can simulate a bone-forming neoplasm when the bone-forming features include enlarged,highly active,immature but uniform osteoblasts that have prominent mitotic activity.These reactive lesions of the bone produce bone and cartilage matrix and are often confused with their neoplastic counterparts,posing a challenge in the appropriate diagnosis and management.We report an operated case of fracture right distal shaft of femur in a 16-year old female,who on follow-up,presented with swelling and pain over the right thigh associated with a single episode of fever.On clinical examination and radiological investigations,a suspicion for cellulitis or localized haematoma formation was kept.The haematoma was locally drained and a core biopsy was taken from the fracture site.Appropriate management was initiated.The tissue sample so obtained was sent for histopathological examination.On histopathological evaluation,it resembled exuberant callus.But in view of presence of exuberant osteoid tissue with many pleomorphic atypical cells,a suspicion of Osteogenic Sarcoma was also kept.Later immunohistochemistry was done on which it turned out to be High Grade Osteogenic Sarcoma,Osteoblastic type.Chemotherapy was initiated in a timely manner,but eventually the patient succumbed to the disease within a course of 4 months from the diagnosis.
Authors and Affiliations
Dr. Shraddha R. Mahindra
Keywords
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