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A 36 year old woman with metatarsal lesion

Case Identification
Case ID Number: 
20091110FP
Periosteal Reaction: 
absent
Benign/Malignant: 
Benign
Clinical case information
Case presentation: 

The patient is a very pleasant 36 year old woman who has noticed a pain in the foot since approximately one month ago.

Radiological findings:: 
Plain radiographs, a bone scan, and MRI are assessed. A lytic, slightly multilocular lesion in the midportion of the second ray is seen. The dimensions are approximately 2 0.5 cm x 1 cm. It seems to extend through one cortex. It does not have any matrix mineralization. It is non-expansile and there is no periosteal reaction.The bone scan shows that the lesion has abnormally increased uptake. The MRI shows a lesion in the above-named location that has bright signal on T2 weighted images. There is destruction of one cortex. There is some surrounding edema.
Further Work Up Needed:: 
This lesion needs to be characterized by biopsy. Possible choices include chondromyxoid fibroma, or other benign lesion. It does not have malignant appearance. Nevertheless, malignancy is still a possibility.