Dear ocaders,
I ask again for your advice.
42 years old female, osteosarcoma of the proximal fibula.
Surgery abroad, dedicated sarcoma center, oncological margins preserved,
curetage of the adjacent tibia, everything went fine (chimio+radio)
July 2020 no recurrence, some tibial areas probably due to radiotherapy
January 2021, after 8 month, tibia is now fine, all areas disappeared, but
there some area of BME (?) ot the tip of the fibular stump.
Some enhancement, not much restriction on DWI, Xray looks normal to me.
Periosteal reaction at the proximal stump?
The question is:
– could NOT be tumor recurrence? There is no mass just diffuse signal
change and enhancement, and this is clearly not seen on the previous
examination…and DWI is not very worrying to me (am I wrong?)
– is it possible to have some late radiation reaction so late (>1 year
since the radiotherapy) ?
– would you do PET-CT? follow up?
Thank you,
Sorin
recidiva-fibula.pdf 