Description: A recent fracture (sharp borders) and multiple (at least 3 fragments) is visible at the level of the distal third of the tibia. The tibial diaphysis has a mottled opacity, caracterised by a permeative ostéolysis. The lesion is predominantly lytic. The transition zone is short meaning that the processus is aggressive and acute. There is also a moderate soft tissue swelling.
Conclusions: Pathologic fracture of the tibial diaphysis secondary to permeative osteolysis of the bone. The diaphyseal localisation at the mid tibia is atypical for a primary bone tumor. This lesion is next to the nutrient foramina which is more in favour of metastasis (hemangiosarcoma, carcinoma...). Less likely this can represents a fungal lesion, although they are usually metaphyseal in location. Other points against fungus is the age of the patient and the geographic localisation (belgium).
The histologic diagnosis was hemangiosarcoma.