PMC4744070_01
Anteroposterior X-rays of the pelvis with both hips showing large, well-defined, expansile lytic lesion in the metaphysis of the proximal femur with a breach in the lateral cortex
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FIG1
Anteroposterior (AP) and lateral view radiographs of the hip and proximal thigh were done (Figure 1), which revealed a large, well-defined, expansile lytic lesion in the metaphysis of the proximal femur extending up to the subtrochanteric region of the femur.
Anteroposterior X-rays of the hip with thigh, immediately post op showing a valgus osteotomy at the subtrochanteric region and fixed with a 95 degree Dynamic condylar screw (DCS) and barrel plate
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FIG2
The osteotomy was fixed with a 95-degree dynamic condylar screw (DCS) and a plate (Figure 2).
Histopathological examination (HPE) revealed spindle to stellate stromal cells embedded in dense fibrous stroma
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FIG3
The removed tissue was fibrocartilaginous in nature, which, on histopathological examination (HPE), revealed spindle to stellate stromal cells embedded in the dense fibrous stroma, along with dense collagen matrix surrounded by thin-walled blood vessels and a few widely scattered thin rims of woven bone, mostly devoid of osteoblastic rimming (Figure 3).
The tissue showed features of a benign mesenchymal lesion with bone matrix and chondroid matrix formation consistent with the characteristics of FCD
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FIG4
Anteroposterior X-rays of the hip with thigh at the one-year follow-up showing correction of the varus and improvement in the lytic lesion of the bone
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FIG5
At the end of one year, the patient was doing well, and the shortening and limp have improved significantly with the radiological union of the osteotomy; there have been no signs of recurrence of the tumor or deformity (Figure 5).