CAJ | 학술논문

Objective To report a case of giant cell tumor of the distal fibula combined with ipsilateral angiolipoma in the tibia.Methods A male patient ( 15 years old ) complained with the intermittent pain in the right ankle for 2 years which was aggravated in one week. Physical examination: swelling of 6cm to the right lateral superior condyle, normal local temperature, no mass, no local tenderness, no limitations of the ankle function. Tibiofibula X-ray of right side: distal metaphysis of the fibula was destroyed expansively, bone mineral density ( BMD ) was decreased, cortex of the bone was thinner, compartment could be seen in the focus of infection, no periosteal reaction or soft tissues. MRI of the right ankle: abnormal nonuniform signals were showed in cavum medullare of the distal ifbula ( 4.5 cm×2.0 cm, equal T1, short T2 ) with clear border, compartment in the focus of infection, and thinner bone cortex; uniform signals were showed in cavum medullare of the distal tibia ( 3.7 cm×1.7 cm, long oval T1, T2 ) with clear border, compartment in the focus of infection, and continuous bone cortex. Curettage of foci in the right distal fibula and tibia, allograft bone transplant and internal fixation were conducted under epidural anesthesia.Results Pathological results: ( 1 ) 5.0 cm×4.5 cm×1.3 cm mass in the cavum medullare of the distal ifbula. Extensive spindle cells with big multinucleated giant cell, local newborn bone trabecular structure were showed in microscope, which were considered to be giant cell tumors. ( 2 ) 3.5 cm×3.0 cm×1.0 cm drab yellow nodule mass in the cavum medullare of the distal tibia. Mature fat cells and minute vessels in microscope were considered to be angiolipoma. Tibioifbula X-ray 10 months postoperatively: ifbular bone graft fusion, no obvious bone damage and bone repair in the operating zone of the tibia.Conclusions Giant cell tumor of the distal ifbula combined with ipsilateral angiolipoma in the tibia was rare in adolescent patients before the epiphyseal closure.