Clinical Cases

This 32 year old Nicaraguan man has multiple lumps on his bones. The one behind his left neck has been growing and is bothering him. He says 5 of his 8 brothers and sisters also have this problem. What does he have? What is the cause of the growth of the tumor behind his neck? What is the correct treatment for this tumor?

An 8 year old Nicaraguan boy has a crooked left leg. He is generally healthy, and has no complaints. His mother says he has pain in his left knee, but he denies this.

A 22 year old woman had a subcutaneous tumor removed from the top of her big toe 6 months ago. The tumor has already started to come back. A photo from before the surgery is shown.

A 20 year old woman has a slowly growing mass adjacent to the ulnar aspect of the middle phalanx of her ring finger. It has been present for 18 months, and is minimally painful. She is otherwise well and there are no other pertinent findings.

This 15 year old boy has a painful tumor in his tibia, near the knee. A biopsy showed "giant cells" in the lesion. It continued to grow, and he has pain, a mass, and substantial leg atrophy.

This 16 year old boy has a slowly enlarging bump or mass on the anterior crest of the tibia, a few centimeters below the tibial tubercle. He is healthy, and the bump does not bother him very much.

A 26 year old woman who is 18 weeks pregnant with her 3rd child presents with a very large mass in the right leg. She is otherwise well and her medical history is unremarkable.

A 51 year old man with osteochondromatosis, who had an enlarging scapular tumor resected 2 years ago now presents with a soft tissue mass in the medial right distal thigh just above the knee.

This 95 year old woman presents with increasing pain and an enlarging mass in her right thigh. She recalls a fall onto the right leg the previous year and has been having ongoing pain since then.

This 10 year old boy sustained a pathological fracture in his right arm whilst catching a football in his arms. On further questioning, this occurred on a background of vague intermittent pain in that arm.

A 52 year old gentleman presents with a 6 month history of pain in his left lower side and left groin. He was admitted to hospital with pain and malaise.

The symptoms have been going on for 18 months. He has been diagnosed and treated by multiple providers for tendinitis, sacroiliitis, and lumbar disc disease. Recently, he has started having soaking night sweats.

A generally healthy 19-year-old woman presents with an 11 month history of a painless ankle mass.

A 38-year-old woman presents with a two month history of severe pain in the right proximal tibia. Actually, the pain was maximal approximately 4 weeks ago, it has improved significantly since.

The 34-year-old man has a 2 year history gradual growth of a slightly tender mass on the index finger. There is no other significant medical history or exam finding.

This is a consult from an ortho clinic in Kenya, a 62 y/o F presents with a transverse, midshaft femur fracture from a low-energy trauma (mechanical fall) about one week ago. She has a history of chronic hip pain for several years. She had been ambulatory prior to the fall. Additionally, she has a very bizarre-appearing hemipelvis and hip joint ipsilaterally.

The patient is 74, with pain and small area of swelling on the left foot for 2 months. The swelling has increased and a definite mass is present. The patient has prostate cancer treated years ago. He quit smoking 40 years ago.

The patient reports an enlarging mass in the left foot for 2 years. Apparently it was small 2 years ago and now is quite substantial. An open biopsy was done, and resection is now planned.

The patient is a healthy 25-year-old woman. She had a bump discovered near her right hip several years ago, that she thought was cellulite. It was not painful then. Recently the bump seems bigger, and it is now symptomatic.

The patient reports an enlarging mass in the left foot for 2 years. Apparently it was small 2 years ago and now is quite substantial. It is painful, she cannot put on a regular shoe, and it is starting to significantly interfere with function