case_images: PMC10050980_01
case_images: Plain radiography reveals altered bone structure of the proximal tibial diaphysis as well as decreased surrounding soft tissue transparency
case_images: PG-18-50389-g001.jpg
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case_images: F1
case_images: Plain radiography did not detect any pathology, although decreased soft tissue transparency around the proximal tibia was seen (Figure 1).
case_images: Pathologic fracture of proximal tibial diaphysis
case_images: PG-18-50389-g002.jpg
case_images: PMC10050980_01_PG-18-50389-g002.jpg
case_images: F2
case_images: She was brought to our emergency department, where a pathologic fracture of the proximal tibial diaphysis was diagnosed on X-ray, just at the level of the prior incision (Figures 2 A, B).
case_images: External bone fixation of left tibia
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case_images: PMC10050980_01_PG-18-50389-g003.jpg
case_images: F3
case_images: The patient underwent emergency surgery, and osteosynthesis was achieved by means of external bone fixation (Figure 3).
case_images: A - Coronal plane of MSCT - osteolytic tibial lesion, B - Axial plane of MSCT - osteolytic lesion in the diaphysis of the left tibia covering almost all the diameter of the bone in this site, C - Axial plane of abdominal MSCT showing rectal mass
case_images: PG-18-50389-g004.jpg
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case_images: F4
case_images: MSCT of the abdomen, thorax, and lower extremities was obtained and revealed rectal tumour with no signs of metastases apart from the osteolytic lesion in the fractured left tibia (Figures 4 A-C).
case_images: Endoscopic finding of the rectal tumour
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case_images: F5
case_images: Furthermore, a colonoscopy was done, and a circular mass in the upper rectum, about 12 cm from the anal verge, was found (Figure 5).
case_images: Histological finding of metastatic CRC in the tibia with preserved bone beds (HE 100x)
case_images: PG-18-50389-g006.jpg
case_images: PMC10050980_01_PG-18-50389-g006.jpg
case_images: F6
case_images: At the marginal parts of the tumour the bone beds were preserved (Figure 6).
case_images: Histological finding of metastatic CRC in the tibia with positive immunohistochemical reaction to CK8 (100x)
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case_images: F7
case_images: Tumour cells showed a positive immunohistochemical reaction to CK8, CK20, BER EP4, and CDX2 (Figures 7-10) and a negative reaction to CK7 (Figure 11, Table I).
case_images: Histological finding of metastatic CRC in the tibia with positive immunohistochemical reaction to CK 20 (100x)
case_images: PG-18-50389-g008.jpg
case_images: PMC10050980_01_PG-18-50389-g008.jpg
case_images: F8
case_images: Tumour cells showed a positive immunohistochemical reaction to CK8, CK20, BER EP4, and CDX2 (Figures 7-10) and a negative reaction to CK7 (Figure 11, Table I).
case_images: Histological finding of metastatic CRC in the tibia with positive immunohistochemical reaction to BER EP 4 (100x)
case_images: PG-18-50389-g009.jpg
case_images: PMC10050980_01_PG-18-50389-g009.jpg
case_images: F9
case_images: Tumour cells showed a positive immunohistochemical reaction to CK8, CK20, BER EP4, and CDX2 (Figures 7-10) and a negative reaction to CK7 (Figure 11, Table I).
case_images: Histological finding of metastatic CRC in the tibia with positive immunohistochemical reaction to CDX2 (100x)
case_images: PG-18-50389-g010.jpg
case_images: PMC10050980_01_PG-18-50389-g010.jpg
case_images: F10
case_images: Tumour cells showed a positive immunohistochemical reaction to CK8, CK20, BER EP4, and CDX2 (Figures 7-10) and a negative reaction to CK7 (Figure 11, Table I).
case_images: Histological finding of metastatic CRC in the tibia with negative immunohistochemical reaction to CK8 CK7 (100x)
case_images: PG-18-50389-g011.jpg
case_images: PMC10050980_01_PG-18-50389-g011.jpg
case_images: F11
case_images: Tumour cells showed a positive immunohistochemical reaction to CK8, CK20, BER EP4, and CDX2 (Figures 7-10) and a negative reaction to CK7 (Figure 11, Table I).