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Presented by Edward McCarthy, M.D. and prepared by Natasha Rekhtman, M.D., Ph.D.
Case 4: A 20 year-old man had pain in his elbow for 6 months.
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1. Question
Week 243: Case 4
A 20 year-old man had pain in his elbow for 6 months. Radiographs demonstrated a lesion in the proximal radius.images/oct 24 2005 case 4 1.jpg
images/oct 24 2005 case 4 2.jpg
images/oct 24 2005 case 4 3.jpgCorrect
Answer: Fibrous dysplasia
Histology: none provided
Discussion: Fibrous dysplasia is common in the cranial skeleton and may involve both the calvarium and/or the facial bones. When present in the skull, fibrous dysplasia is often accompanied by extensive aneurysmal bone cyst formation. Histologically, there is a fibroblastic stromal with seam of new bone deposited “alphabet soup pattern.” There is no atypia in the fibrous stroma. In addition, there are zones of aneurismal bone cyst with dilated blood-filled lakes and fibrous septae.
The lesion is not a fibrosarcoma or an osteosarcoma because the cellular pleomorphism present in both these tumors is absent in this case.
Incorrect
Answer: Fibrous dysplasia
Histology: none provided
Discussion: Fibrous dysplasia is common in the cranial skeleton and may involve both the calvarium and/or the facial bones. When present in the skull, fibrous dysplasia is often accompanied by extensive aneurysmal bone cyst formation. Histologically, there is a fibroblastic stromal with seam of new bone deposited “alphabet soup pattern.” There is no atypia in the fibrous stroma. In addition, there are zones of aneurismal bone cyst with dilated blood-filled lakes and fibrous septae.
The lesion is not a fibrosarcoma or an osteosarcoma because the cellular pleomorphism present in both these tumors is absent in this case.
