A 20-year-old female presented four years after curettage/bone grafting of a giant cell tumor of the talus with pain in the ankle.
Screening radiographs demonstrated a healing of the talar lesion, but a large, destructive, radiolucent lesion was noted in the distal tibia at the site of the previous, presumed-healed, nonossifying fibroma (see encounter l).
An incisional biopsy demonstrated conventional, giant cell tumor; and, because of the large, destructive nature of the lesion, a below-knee amputation was done.
Gross and microscopic examination revealed an aggressive, Stage 3, giant cell tumor of the distal tibia with apparent, complete healing of the previously-treated lesion in the talus.Five years later, the patient developed a lesion in the proximal tibia (see encounter 3).
[X-Ray] AP radiograph of the ankle at presentation.
[X-Ray] AP radiograph of the ankle at presentation, magnified.
[Gross Path] Sagittal surface of the bisected surgical specimen.
[Macro] Sagittal macrosection.
[Micro] Histosection from the interior of the lesion - X20.
[Micro] Histosection from the interior of the lesion, magnified.
[Micro] Histosection from the interior of the lesion - X60.