An 8-year-old male child, born to healthy parents, with no relevant pathological history, presented with a progressive appearance of a tumor in the anterior region of the right knee.
She reported no pain, functional impotence or gait alteration.
Physical examination showed complete range of motion of the knee, with no wishes or limb length discrepancy.
No other identifiable lesions existed.
Neurovascular examination revealed no abnormalities.
The initial radiographs showed a localized lesion in the epiphysis and anterior tuberosity of the tibia.
The radiographic characteristics were suggestive of a benign lesion.
An open sky biopsy was performed through an anterior approach, which respected the extensor mechanism.
Macroscopic features were similar to those of an osteochondroma.
Histological findings confirmed the diagnosis.
1.
Eight months after resection the mass recurred in the same location.
On this occasion, the patient presented with pain and limitation to physical activity.
A second resection was performed with the same approach.
Complete resection of the lesion with fluoride was confirmed intraoperatively.
Two years after the first surgery, there was a second recurrence of the lesion, although at this time the discomfort was occasional with normal activity.
Magnetic resonance imaging revealed the involvement of most epiphysis.
Due to the possibility of producing an early closure of the physis with more radical surgery, it was decided to postpone it until skeletal maturity of the patient or until the symptoms were disabling.
