38 years old female patient referred by GP with right hand pain in the area of third metacarpal bone. No history of trauma. No prior medical or surgical history.
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Solitary, expansile, lytic lesion in the right middle finger metacarpal head. There is minor cortical breach in its inferior medial aspect. No periosteal reaction. No surrounding soft tissue abnormality.
Enchondroma was top differential for the lesion, however patient presented with extreme pain in the area without history of trauma.
Biopsy was performed and histopathology showed that the lesion represented chondrosarcoma.
The case emphasizes how important it is to evaluate further simple looking bony lesions if patient reports pain, especially in absence of trauma history.