PMC7276625_01
Pre-operative anterior-posterior X-ray view of the pelvis (a) and proximal lateral X-ray view of the femur (b) demonstrating a large, aggressive appearing lesion with mixed lytic and blastic features with a thin cortical rim over the margin medially about the proximal right femur.
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F1
Radiographs were obtained by her primary care provider, which demonstrated a large, aggressive lesion with some mixed lytic and blastic features about the proximal femur (Fig. 1).
Pre-operative coronal T1-weighted magnetic resonance imaging (MRI) (a) and coronal T2-weighted MRI (b) of the pelvis demonstrating an aggressive lytic appearing lesion near the inferomedial femoral neck and lesser trochanter extending through the cortex with a softtissue mass of approximately 6cm in size. The soft tissue mass abuts the iliopsoas and vastus musculature appearing to cause an adjacent mass effect.
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F2
Magnetic resonance imaging was obtained and demonstrated an aggressive appearing lesion centered near the inferomedial femoral neck as well as the lesser trochanter (Fig. 2).
(a and b) High-power photomicrographs from curettage specimen stained with hematoxylin and eosin demonstrating proliferation of relatively uniform large polygonal cells (black arrow) with eccentric round nuclei and abundant eosinophilic cytoplasm. These cells were associated with the formation of new woven bone (white arrow) seen growing in large sheets.
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F3
Sections from the curettage specimen showed a proliferation of relatively uniform large polygonal cells with eccentric round nuclei and abundant eosinophilic cytoplasm (Fig. 3).
Imaging at 1-year follow-up with anterior-posterior X-ray view of the right femur (a) and proximal lateral X-ray view of the right femur (b) confirmingthe placement of the short cephalomedullary intramedullary nailwith bony union.No hardware complications or lesion recurrence present.
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F4
One year post-operative imaging did not reveal any hardware complications or lesion recurrence (Fig. 4).