PMC6118118_01
(a) Large swelling in the left ankle. (b) X-ray left ankle revealed expansile osteolytic destruction of the body of talus extending to lower end of tibia and fibula with soft tissue involvement
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F1
The swelling was large (10 cm x 5 cm x 5 cm), fluctuant, progressively increasing in size, and associated with pain [Figure 1a]. His X-ray left ankle revealed expansile osteolytic destruction of the body of talus extending to the lower end of tibia and fibula with soft tissue involvement [Figure 1b], and clinical differential diagnosis of giant-cell tumor (GCT) or osteosarcoma was considered.
(a-d) Fine-needle aspiration cytology of the swelling showed cellular tumor with osteoblasts (thin arrow), scattered giant cells (thick arrow), and spindle cells entangled in myxoid matrix (May-Grunwald-Giemsa, x40; H and E, x40). (e and f) Histopathological examination showed cellular osteoblastic tumor with ectatic blood vessels and scattered giant cells (thick arrow) (H and E, x40)
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F2
The patient was subjected to FNAC which showed cellular smears with the presence of mononuclear and binucleated osteoblasts along with scattered osteoclastic giant cells and uniform spindle cells entangled in myxoid stroma [Figure 2a-d]. In view of the large lesion, surgical excision was performed and subsequent histopathology confirmed the diagnosis of osteoblastoma [Figure 2e and f].