cystic degeneration of fibrous dysplasia masquerading as sarcoma

CYSTIC

DEGENERATION

OF

MASQUERADING A.

H.

R. W.

SIMPSON,

An area degeneration indistinguishable

D.

the Nuffield

M.

DYSPLASIA

SARCOMA

WILLIAMSON,

Orthopaedic

D.

Centre,

J. WILSON,

in one of our cases

and was the only

imaging

J. S. SPIVEY

Oxford

of fibrous dysplasia of bone may undergo rapid enlargement or malignant transformation. These complications may and, unless both are borne in mind, incorrect management

was used

imaging

AS

T. S. CREASY,

From

FIBROUS

modality

which may be due to either cystic be clinically and radiologically may follow. Magnetic resonance

to demonstrate

the true nature

of the

condition. Fibrous

dysplasia

separate

entity

of

and

endocrine ment in

form

may

be

is often

rent

been

Malignant complication

with

and syndrome

precocious (1937).

to

change both

in

forms. Schwartz literature, found fibrous dysplasia,

be

skin

innocuous,

is a rare but the monostotic

seven fibrosarcomas, giant cell sarcoma. They

of malignant

change

well and

for the monostotic

with of

clinical

features

and

certain

Case

lower

1. A 39-year-old right

side of his chest

the 18

showed

A. H. R. W. Simpson, BM

BCh,

MA,

FRCS,

Radiology

Correspondence

©

Orthopaedic should

Centre, be sent

incomplete Her

radiographs cases were dysplasia

of pain a tender

in the

swelling

of

Orthopaedic

Registrar

Headington, A.

434

line.

His

months

previously

half this size was active

had

with on

well bone

dysplasia

with

alkaline

picture

was

phosphatase

Radiographs sion of the (Fig.

presented Clinical

cystic syndrome many ribs

with gradual onset examination revealed

of an

paraparesis. blood

of

showed proximal

3), with

a left

normal

207

except

SI

units

for

pleural

effusion.

Myelography

indistinct change revealed

a raised

(normal

marked disorganisation ends of the left fourth

an expanding lesion with thought to be sarcomatous