Diagnostic Dilemma in a Distal Femoral Intramedullary Lesion: Enchondroma Mimicking Low-Grade Chondrosarcoma with Discordant Biopsy Findings: A Case Report.
Differentiating enchondroma from low-grade chondrosarcoma remains challenging due to significant overlap in clinical presentation, imaging characteristics, and histopathological appearance. Accurate diagnosis is crucial in guiding appropriate treatment and preventing unnecessary aggressive management.
A 25-year-old female presented with progressive right knee pain for 20 days. Te X-ray was inconclusive. Magnetic resonance imaging demonstrated a well-defined intramedullary lesion within the distal femur measuring approximately 7.6 × 2.6 × 3 cm. Initial computed tomography (CT)-guided biopsy results were inconclusive. Repeat imaging, including magnetic resonance imaging and positron emission tomography-CT, suggested a non-aggressive lesion without metastatic disease. After multidisciplinary tumor board discussion, a repeat biopsy demonstrated a cartilaginous neoplasm compatible with enchondroma. The patient subsequently underwent intralesional curettage with antibiotic-loaded bone cement filling. Final histopathological analysis confirmed a benign enchondroma.
This report highlights the importance of clinicoradiological correlation and repeat biopsy when initial investigations provide conflicting information in suspected cartilage tumors.
A 25-year-old female presented with progressive right knee pain for 20 days. Te X-ray was inconclusive. Magnetic resonance imaging demonstrated a well-defined intramedullary lesion within the distal femur measuring approximately 7.6 × 2.6 × 3 cm. Initial computed tomography (CT)-guided biopsy results were inconclusive. Repeat imaging, including magnetic resonance imaging and positron emission tomography-CT, suggested a non-aggressive lesion without metastatic disease. After multidisciplinary tumor board discussion, a repeat biopsy demonstrated a cartilaginous neoplasm compatible with enchondroma. The patient subsequently underwent intralesional curettage with antibiotic-loaded bone cement filling. Final histopathological analysis confirmed a benign enchondroma.
This report highlights the importance of clinicoradiological correlation and repeat biopsy when initial investigations provide conflicting information in suspected cartilage tumors.