J Korean Orthop Assoc.  1975 Sep;10(3):306-313. 10.4055/jkoa.1975.10.3.306.

A Case of Juxtacortical Osteogenic Sarcoma of the Upper Third of the Fibula

• Lee JY
• Yoo CI
• Kim BH
• Shon BH
• Byon JY

• KMID: 2471433
• DOI: http://doi.org/10.4055/jkoa.1975.10.3.306

Abstract

The lesion of bone originally described by Geschickter and Capeland in 1951 as parosteal osteoma is now generally recognized as a distinctive type of osteogenic sarcoma with characteristic clinical roentgenographic and pathologic features. Juxtacortical osteogenic sarcoma is the most widely accepted in the literature, that name is used here. A case of juxtacortical osteogenic sarcoma of the upper third of the left fibula is reported together with review of the literature. The involvement of the upper third of the left fibula is extremely rare. A man, fifty-seven years old, for 3 years noticed intermittent swelling after vigorous exercise and subsiding after rest of the proximal part of the left leg. A month prior to admission, this swelling became progressively larger. The presenting complaint was hard, nomovable, nontender and, lobulated large mass on the posterolateral aspect of the upper part of the left leg. Roentgenographic examination revealed a peripheral diffuse soft tissue swelling and a central lobular osseous mass with distinct margin, dense shadow encircling the shaft and narrow radiolucent zone between the tumor and shaft below the osteosclerotic base on the posteromedial aspect of the upper third of the left fibula. This patient had laboratory studies within normal limits. It is treated by segmental resection. Histological finding revealed fibrosarcomatous pattern with more or less interlacing bundles of fibroblast-like cells and fibers and scattered mass of atypical cartilage tissue composed of atypical chondrocytes with pleomorphic, hypochromatic and hyperchromatic nuclei, among which there were bone spicules.

MeSH Terms

Cartilage
Chondrocytes
Fibula*
Humans
Leg
Osteoma
Osteosarcoma*

Figure

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  㽔㘼 1. 㟼⤼䖌 䏱 ㇟䖌㼿 : 㨐䊀㞐㘿㝻㏃, 㝴㇟ 㼿 •ᅩ 䊀㣼㨰㻤 ⤼佌㇟㣄䞤 䰴㉤⪤ 匘㻏㝻䓄 䏱 凐㠀 䊀⪨䊀㨰 narrow radiolucent [zone(佨⮤)·§·䌌 㢌䖐 ⪨ ᅵ·䊀㣼 千匘 䏱 㼿 ᅵ·䊀㣼 䆼匘㨰 㦼 㟼 ㆨ㣠䯤 㘼劔㻏 匘㟸㼿㢼 䌌㡼.

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  㽔㘼 2. 䰧䘛㋔㧿㼿:㟼⤼千匘䰧䘛㽔㢌 叼南㢌 㝻㩯㞐 㘿㨰 㦈⪌ 仭⨀㟈 㡸㣄佨 㜄⩷䏗⩛ 䏱 㣜匃㣀 厐㢨 㟫㼿㣄䞤 䌌㡼.

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  㽔㘼 3. 㟤厐㷠⤼ 㟼䖌㼿 䉼㨃㼿㝻㩯㞐㘿 (9X6X4 cm) 㢌 㻔㣠 䏱 刄㣟㞐㘿㣄䞤 䯤 ⫄䘷㣄䞤 䲒⨀ 㡸 㣄䖐 㟼䖌䊀匘叼㣀 䆼劰㟿 㟫㼿㡼.

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  㽔㘼 4. 㟤厐㷠⤼⤼䖌㼿:㝻㩯㞐㘿㨰 㢨⪌ 匘叼㢌 䊀 䉼㟿㣄䞤 㨰㤴㴈㨔 㡸㣄䖐 㝻㩯㣀 ⤼佌䏗㣄䞤 䬜㉤⪨匠 㡸䴜. 䆼劰㟿 㟫㼿㟿㣄䞤 䌌㡼.

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  㽔㘼 5. ⥟䴘䖌㼿:⥴䏏㼷㢨 匘㞐㘿 㨐匘 䏱 刄㣟㞐㘿 㢌 䌌㢌䖐 体㝻⧫㻏 䏱 勌㽔⧄㟿㣀 㨺匠 凐㠀 䊀吀 㼿 ᅵ·䊀㣼㨰 䊀㏗䯨㩌 㡸㣄䖐 匘㷨叫㣀

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  㽔㘼 6. 㠀䏐㢼㼿: fibroblast-like cells æ fibers 吀 䐀㘯ΐ㩌 佨⽀佘.

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  㽔㘼 7. 䏐㢼㼿 : 䴜⧫㍌㟿㢌匠 ⳴㨄㼷㻏⪋㢼 吀㘼 str- omal cells 㢌 䐀㘯⪨㨔 佨⽀佨匠 㻈Ⱄ䉼㨌㼿 䰼 䌌㢌䵬 㻔㣠㣟㝻㼿 㹴協.

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  㽔㘼 8. 㠀䏐㣜㼿 : 㼿䊀㨰䵬 ㆘㼿匘 㛯叼䊀䵬 㨐匘㞐㟣 ⪨䊀㨰䵬 㨐匘㞐㘿㨰㻤 匘⧫㻏㼿㢼 䌌㡼.

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  㽔㘼 9. 匠䏐㣘㼿 : 䴜⧫㍌㟿㢌匠 匄凷㠀 㨄㼷㻏⪋㢼 吀- 㘼 䆼㟼⧫㟿 㨐匘㻈Ⱄ䞤 劔㻏䯤 㨐匘㣟㝻㼿㢼 䌌㡼.

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  㽔㘼 10. 㝴㇟⪨⸌ 㟼⤼䖌 䏱 ㇟䖌㼿 : 䆼匘㼿 5 inches 䚄䊀䉼㟸㟤⪤⤼ 䴀⸌ 2䮰刄厌 䏱 㦈㇟㇟䊀 㢈䴀 䚄 staple 䞤 匠㟫 㴤 ⽌.

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