Fracture callus associated with benign and malignant bone lesions and mimicking osteosarcoma.

Abstract

Reparative callus associated with ordinary fractures causes no problem to the pathologist and orthopedic surgeon, but fracture callus superimposed on benign and malignant bone lesions may cause considerable diagnostic difficulty to the surgeon, radiologist, and pathologist alike. Misinterpretation of this callus as osteosarcoma may lead to an unjustified amputation. We feel that this has not received adequate documentation in the literature, and we have thus presented some representative cases which help to clarify this problem. These include three benign lesions of bone and one metastatic lesion to bone. In three cases, fracture callus complicating the underlying disease process was sufficiently disturbing to cause the pathologist to seek other opinions, and in one case an amputation for metastatic disease was performed. The careful correlation of all available clinical, radiologic, and pathologic features of each case at the time of study of the biopsy was found to be the most important factor in preventing diagnostic errors.