Role of multimodality imaging for primary bone tumors among children: a case report

Abstract

ABSTRACT Background: Bone lesions in children are very common and can be benign or malignant. Benign bone lesions, fortunately, are more common as compared to rare malignant neoplasms of bone. Osteosarcoma and Ewing sarcoma are the most common malignant bone tumors in younger age group. Multimodality imaging plays a major role in bridging the gap between clinical diagnosis and final diagnosis Case Presentation: We present here a case of 8-year-old male patient complained of progressive soft tissue swelling and pain in left thigh from 25-30 days. His X-ray of left femur showed a mixed density, predominantly sclerotic lesion involving mid-diaphysis. His contrast enhanced MRI of left thigh showed large, ill-defined, abnormal signal intensity medullary lesion seen in left femur involving mid to lower diaphyseal shaft, extending to metaphyseal region. His 99mTc MDP bone scintigraphy was done showing abnormal radiotracer uptake in lower half of left femur and adjoining soft tissue. Conclusion: Single modality imaging may not be enough in predicting the true extent of bone pathologies. Multimodality imaging plays a major role in characterizing the lesions to differentiate benign from malignant and bridging the gap between clinical diagnosis and final diagnosis. Keywords: Osteosarcoma, Ewing sarcoma, 99mTc MDP bone scintigraphy, case report