Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive, deep-seated pain in the proximal lateral aspect of the lower extremity, exacerbated by activity and nocturnal rest. Notable for localized swelling, palpable firm mass near the fibular head, and progressive functional impairment of the knee joint. No history of recent trauma. Systemic symptoms include unexplained weight loss and fatigue.
Clinical Examination Findings
Physical examination reveals a firm, non-mobile, tender mass localized to the proximal fibula. Overlying skin shows prominent superficial venous engorgement. Knee range of motion is restricted by pain and mass effect. Neurovascular assessment of the common peroneal nerve is critical; check for foot drop or sensory deficits in the first dorsal web space. Distal pulses are intact.
Treatment Protocol
Multidisciplinary management initiated. Plan includes neoadjuvant chemotherapy to achieve tumor necrosis, followed by surgical resection (en bloc resection of the proximal fibula). Reconstruction options include allograft or autograft stabilization. Post-operative physical therapy and long-term surveillance for local recurrence and pulmonary metastasis are mandatory.