Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressive, palpable, firm mass along the anterior tibial diaphysis. Reports localized dull ache, exacerbated by activity and nocturnal progression. No history of antecedent trauma. Denies systemic B-symptoms, weight loss, or constitutional fatigue.
Clinical Examination Findings
Physical exam reveals a non-mobile, tender, firm mass fixed to the anterior tibial cortex. Overlying skin is intact without erythema or increased warmth. Neurovascular status of the distal extremity is intact with palpable dorsalis pedis and posterior tibial pulses. No palpable inguinal lymphadenopathy.
Treatment Protocol
Recommended management includes multi-agent neoadjuvant chemotherapy followed by wide surgical resection of the tibial diaphysis and limb-salvage reconstruction. Post-operative adjuvant chemotherapy to be determined based on histological response and margin status.