Author(s): Erica Marto, Gonçalo Silva, Francisco Serra, Diogo Barros, Catarina Souto and Vânia Oliveira

Abstract: Introduction: Pseudotumors are non-neoplastic lesions that clinically and radiologically mimic true tumors. They often arise from chronic inflammatory or infectious processes, posing significant diagnostic challenges. Case Presentation: A 48-year-old male with a remote history of a motor vehicle accident in 1996 resulting in a left leg fracture and sciatic nerve injury after hip dislocation was referred for evaluation of a progressive swelling in the left leg. He had previously undergone tibial intramedullary nailing and developed an asymptomatic fibular nonunion. In 2022, an apparent cystic lesion at the site of fibular pseudarthrosis was excised elsewhere. Subsequently, the patient presented with recurrent pain and progressive deep swelling, raising suspicion of a soft tissue or bone tumor. Multidisciplinary evaluation suggested a pseudotumoral lesion. Microbiological culture revealed Streptococcus viridans, and histopathology excluded malignancy. Surgical en bloc resection of the pseudotumor with segmental fibular resection confirmed infection with Staphylococcus capitis, without neoplastic cells. The patient completed 6 weeks of doxycycline and remains asymptomatic with no radiological recurrence. Conclusion: This case highlights the diagnostic and therapeutic complexity of infected pseudarthrosis mimicking neoplasia and reinforces the need for multidisciplinary management and preoperative biopsy in suspicious musculoskeletal lesions.

DOI: 10.22271/27078345.2025.v7.i2e.297

Pages: 270-274 | Views: 129 | Downloads: 63

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