case_images: PMC8311747_01
case_images: (A) Gross appearance of the mass at anteromedial aspect of the leg and previous biopsy scar. (B) Anteroposterior and lateral radiographs of the tibia. (C) Axial. (D) Coronal. (E) Sagittal T2-weighted images showing high-intensity signal lobules with striations extending from proximal epiphyseal border to distal tibia with soft tissue expansion
case_images: stlr-16-60-g001.jpg
case_images: PMC8311747_01_stlr-16-60-g001.jpg
case_images: F1
case_images: There were no other masses (Fig. 1A). There was a lattice-like pattern with horizontally and vertically oriented striations within the entire lesion (Fig. 1B). Magnetic resonance T2-weighted images showed multiple high signal intensity lobules with multiple septations containing several round areas of low signal intensity (Figs 1C to E).
case_images: (A) Resection of tibia. (B) Resected mass measuring 24 cm in length and 12 cm in maximum diameter
case_images: stlr-16-60-g002.jpg
case_images: PMC8311747_01_stlr-16-60-g002.jpg
case_images: F2
case_images: Distally, the tibia was cut 1 cm beyond the intramedullary extent of the tumour, leaving 3 cm of distal tibia (Fig. 2A). The entire resected specimen measured 24 cm in length and 12 cm in maximum diameter (Fig. 2B).
case_images: (A) Anteroposterior. (B) Lateral views of the leg showing Ilizarov construct and the olive wires at the fibula. (C) Follow-up radiographs show callus formation at graft-host junction
case_images: stlr-16-60-g003.jpg
case_images: PMC8311747_01_stlr-16-60-g003.jpg
case_images: F3
case_images: The fibula was percutaneously osteotomised at two levels corresponding to the cuts of the remaining portions of the proximal and distal tibia (Figs 3A to C).
case_images: Radiographs at 38 months after surgery showing union at proximal and distal graft-host site with fibular hypertrophy
case_images: stlr-16-60-g004.jpg
case_images: PMC8311747_01_stlr-16-60-g004.jpg
case_images: F4
case_images: At 6 months, radiographs showed healing at both distal and proximal ends (Fig. 4). Radiographs at 38 months showed union at proximal and distal graft-host sites with fibular hypertrophy (Fig. 4).
case_images: Patient at 38 months postoperative, with flexion up to 100
case_images: stlr-16-60-g005.jpg
case_images: PMC8311747_01_stlr-16-60-g005.jpg
case_images: F5
case_images: At review, the patient has no pain, has full knee extension and has up to 100  of knee flexion (Fig. 5).