PMC5511719_01
(A,B) plain radiographs showing a metaphyseal osteolytic lesion of the distal left tibia; (C,D) MRI, an extension to the adjacent soft tissue and no epiphyseal involvement
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The plain radiographs showed a metaphyseal osteolytic lesion of the distal left tibia (Figure 1). Imaging (MRI) was also demanded in order to define the extent of marrow involvement. It showed an extension to the adjacent soft tissue and no epiphyseal involvement (Figure 1).
(A) per operative aspect; (B) a wide resection of tibia and fibula along 12 cm from the tibio-talar joint performed with a tumour free margin of 3 cm; (C,D) post-operative plain radiographs
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We opted for the standard anterior-lateral approach to the distal end of tibia (Figure 2). After parents' consent, we did a wide resection of tibia and fibula along 12 cm from the tibio-talar joint performed with a tumour free margin of 3 cm (Figure 2).
(A, B) plain radiographs post reconstruction
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A reconstruction of the distal tibia was made 3 months after tumor resection (Figure 3).
(A, B) plain radiographs after osteosynthesis with plate
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So, we opted for treatment by osteosynthesis with plate (Figure 4).