Case 8

The patient was a 13-year-old girl with a 2-year history of pain and slowly growing tumor on the diaphysis of the left tibia. There was no history of previous trauma. On clinical examination a 6×4 cm hard swelling was found on the anteromedial aspect of the tibia. Serum alkaline phosphatase was moderately raised to 22.5 μkat/L (normal value > 16 μkat/L). Radiologic examination revealed a 6 × 4 × 4 cm, mainly osteolytic, destruction surrounded by sclerosing bone and periosteal thickening. Curettage was performed at the county hospital, but the patient was referred to the Karolinska Hospital 4 months later because of recurrence (Fig. 1). A radical local resection and autologous bone transplantation were performed (16 cm of tibia including the tumor and a good margin of healthy soft tissue were resected). Grossly, a soft reddish tumor causing destruction of the bone was found. Two and one-half years after surgery the patient was well without signs of recurrence or metastases.