Question

a 10-year-old male patient presents with chief complaint of right knee pain. you note swelling overlying the right knee and calf. radiographic examination of the region reveals a permeative osteolytic lesion in the diaphysis of the tibia with laminated and spiculated periosteal reactions. what is the most likely diagnosis? a) fibrosarcoma b) osteosarcoma c) ewing sarcoma d) chondrosarcoma

Explanation:

Ewing sarcoma typically presents in children/adolescents, often with bone pain and swelling. Radiographically, it shows permeative osteolytic lesions in the diaphysis of long bones (like the tibia) with laminated ("onion skin") and spiculated periosteal reactions, matching the case details. Osteosarcoma usually involves metaphyseal regions, while fibrosarcoma and chondrosarcoma are more common in older adults and have distinct radiographic features.

Answer:

C) Ewing sarcoma