Malignant Transformation of Monostotic Fibrous Dysplasia after Surgery: A Case Report

Introduction: Fibrous dysplasia (FD) is a benign lesion characterized by replacement of normal bone with abnormal connective tissue. It occurs in monostotic or polyostotic forms, with a rare but proven potential for malignant transformation. Symptoms of acute pain, rapid swelling, or an enlarging mass should increase suspicion for possible sarcomatous change. Complete surgical resection is the mainstay of treatment, and chemotherapy is recommended to improve survival. Case Report: A 52-year-old male presented with a painful, enlarging mass on the right proximal thigh 2 years after undergoing plate fixation of the distal femur for a pathologic fracture secondary to monostotic FD. Diagnostic imaging revealed signs of recurrence, and core needle biopsy revealed aggressive features suggestive of malign ant transformation. Following surgical resection and chemotherapy, the outcome has been uneventful without evidence of recurrence or metastasis at 4-year post-operation. Conclusion: Malignant transformation in monostotic FD is rare. Symptom exacerbation should increase the suspicion for sarcomatous change and prompt the need for diagnostic imaging as well as histologic confirmation.

Analysis of X-ray Patterns in Infection and Tumor

In diagnosis of bone tumor, X-ray is as important, if not more important than pathology report. However, X-ray had specific disadvantage. Tumor mimics especially infection can have same appearance as tumor in the X-ray. In this article, author analyzes the different patterns of X-ray changes common to tumor and infection and points outs that X-ray depicts the aggressiveness of the condition rather than a specific diagnosis