Case of the Month

Answer to September 1998 Case of the month.

Treatment for this patient consisted of 1) functional rehabilitation for the ankle sprain. 2) Observation with  follow-up exams and radiographs for the tumor.  See below for follow-up radiographs one year later and two years later.  Click on the images for a better view.

Radiograph taken approximately one year later.
The lesion is still present, but no growth or progression has occurred.  Longitudinal growth of the bone has made the lesion seem to move away from the growth plate.

Radiograph taken approximately two years later.
The lesion shows no evidence of progression or aggressive behavior.  It seems to have become smaller, but this is likely to be due to relative increase in size of the tibia due to continued growth.  The lesion seems to have moved farther away from the growth plate.  This lesion is likely to involute after skeletal maturity

In this case, it was felt that the tumor had no causal relationship with the sprained ankle, and that this lesion did not pose a threat of pathological fracture that was high enough to warrant surgical treatment.   The patient was allowed to continue to play soccer and participate fully in gym class. 

See some methods for evaluating the risk of pathological fracture here. 

Get more facts about this particular bone tumor  here.