PMC3523428_01
First presentation with small eccentric lucent lesion
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F1
At that time, the plain radiography of the right knee demonstrated a small well-circumscribed eccentric lesion in the proximal medial metaphyseal region of the tibia without disruption of the cortex (Figure 1), and the patient had been treated conservatively with suspicious of fibrous cortical defect.
Rapid expansion of lesion after three months
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F2
3 months later she was referred to our clinic with a new plain radiography, which demonstrated a large well-defined centric lytic lesion with involvement of both medial and lateral portion of proximal tibial metaphysis, without disruption of cortices and physis (Figure 2).
Sagittal view shows expansile centric, septated cystic lesion
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F3
MRI reported an expansile centric, septated cystic lesion in metadiaphyseal part of the right tibia without fracture or secondary changes in muscular component (Figure 3).
Histological examination shows highly vascular lining with giant cells and hemosiderin deposition
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F4
Histological examination revealed highly vascular thin membranous lining composed primarily of epithelium-like cells and giant cells accompanied with hemosiderin deposition (Figure 4).
Curettage of lesion grafted with bone substitute
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F5
After confirmation of the diagnosis, the patient underwent curettage and grafted with bone substitute (Figure 5).