Ewings Tumour LSBU

Description: Boy aged 7 years with pain and swelling in his right leg. There is a patchy lytic lesion with some expansion of the lower section of the diaphysis of the left tibia. The endosteal margins of the lesion are ill-defined, having a wide zone of transition between normal and abnormal bone. There is an extensive lamellar periosteal reaction. This extends over the distal metaphysis and is particularly marked over the interosseus ligament, medial to the expanded diaphysis of the tibia. There is an additional patch of bone loss on the lateral side of the distal metaphysis. The epiphyseal plate seems preserved. There are two additional 'dark' lines of decreased radiodensity. These appear more pronounced than fat density and probably represent air from a previous biopsy. Variation of soft tissue density on the lateral side may be tortuous veins, related to the vascularity of this pathology.