PMC5109267_01
Clinical and X-ray Findings.
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The size of the lump clinically was 5 cm by 6 cm with shiny skin, clear border, firm in consistency, and fixed to the bone (Fig. 1a). On the right and left knees, we found non-tender multiple lumps (Fig. 1b). The x ray of left wrist revealed osteolytic lesion with some geographic patterns (Fig. 1c).
Post wide excision and reconstruction using fibular graft.
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We found multiple bony masses with clinical characteristics of multiple exostosis on the proximal site of fibular graft (Fig. 2a). The distal part of the graft was transfixed with Kirschner wire (Fig. 2d). The patient feels no pain, already returned to regular activities, range of motion return to 75-99% and the grip strength is 100% (Fig. 2e).
The histopathological result.
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Histopathological finding revealed GCT with an eosinophilic cytoplasm, round ovals nucleus, vesicular chromatin with small nucleus prominent, and a slight mitosis (Fig. 3).
The immunohistochemistry result (EXT-1 and BCL-2).
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Immunochemistry finding revealed existence of EXT-1 but no existence of BCL-2 (Fig. 4).