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09 August 2013 : Case report  South Korea

A case report of xanthogranulomatous osteomyelitis of the distal ulna mimicking a malignant neoplasm

Unusual clinical course, Challenging differential diagnosis, Diagnostic / therapeutic accidents, Rare disease, Educational Purpose (only if useful for a systematic review or synthesis)

Seung Hyun LeeABEF, Young Han LeeABEF, Heejung ParkD, Yong Jin ChoC, Ho-Taek SongF, Woo Ik YangA, Jin-Suck SuhACF

DOI: 10.12659/AJCR.889422

Am J Case Rep 2013; 14:304-307

Abstract

Background: Xanthogranulomatous inflammation is a chronic inflammatory disease in which bone involvement is extremely rare. Bone involvement of xanthogranulomatous inflammation, termed xanthogranulomatous osteomyelitis (XO), often presents as a mass-like lesion extending to adjacent structures, which can mimic infiltrative carcinoma.
Case Report: We present a case of XO in the ulna, which mimicked a neoplasm. A 59-year-old man presented with a 2-month history of painful swelling in the right wrist. Plain radiography and CT showed an osteolytic lesion at the distal ulna. MRI revealed a soft-tissue mass with lobulated margins and contrast enhancement. Intense uptake in bone scan and PET suggested malignancy. An excisional biopsy from the representative area resulted in a pathology diagnosis of XO.
Conclusions: Gross and radiologic manifestations of XO can mimic neoplasm. XO generally has benign prognosis, contrary to malignant bone tumor. Therefore, biopsy and histopathological confirmation are necessary for proper management.

Keywords: Xanthogranulomatous osteomyelitis, inflammatory, Ulna

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923