RESUMO
INTRODUCTION AND IMPORTANCE: Clavicular osteomyelitis, unlike the metaphysis of long bones, is a rare condition that poses a challenge for orthopedic surgeons in terms of diagnosis. The unique location of the clavicle makes it crucial to diagnose and effectively manage these non-traumatic clavicular lesions promptly. Localized pain and swelling are common symptoms experienced by patients with clavicular osteomyelitis. CASE PRESENTATION: A 9-year-old boy presented with swelling and pain in the left clavicular area for 6 months. There was no fever or history of trauma. Physical examination revealed a tender, 2 cm by 3 cm swelling over the left clavicular area, with no abnormal findings in other body systems. This case was treated with surgical debridement and PO cloxacillin, and his condition improved. CLINICAL DISCUSSION: To achieve an accurate diagnosis, a thorough analysis of the patient's clinical presentation, along with blood workups, radiologic studies, bacteriological studies, and histopathological studies, is essential. Treatment options for clavicular osteomyelitis may involve surgery, medical intervention, or a combination of both. Existing literature suggests that the cure rate does not significantly differ between patients who receive medical treatment and those who undergo surgery for clavicular osteomyelitis. CONCLUSION: In evaluating non-traumatic clavicular lesions, considering chronic osteomyelitis as a potential diagnosis is important. The final diagnosis is determined through analysis of the clinical presentation, laboratory and radiographic tests, and confirmation with assistance from local culture and biopsy.
RESUMO
INTRODUCTION AND IMPORTANCE: Extraskeletal Ewing's sarcoma is an uncommon tumor with a devastating prognosis and a very high mortality rate, particularly in metastatic forms, it primarily affects young people mainly in the 2nd to 4th decades of life. It can affect different parts of the body, without a particular clinical presentation which delays diagnosis. CASE PRESENTATION: 12-year-old male patient presented with swelling over the left proximal thigh of 7 months duration associated with pain and limping. On physical examination, he had about 20 × 15 cm firm, tender, and erythematous proximal left thigh swelling that is fixed to the structures with an overlying scar. CLINICAL DISCUSSION: Extra skeletal Ewing's sarcoma (EES) is a member of the Ewing Sarcoma Family of tumors. EES is a rare tumor with an incidence ranging from 0.1 to 0.4 per a million people. It presented with rapidly increasing swelling mainly over the soft tissue of the proximal thigh, pelvis, paravertebral region, chest wall, upper arm and shoulder. Age at presentation ranges 10 to 30 years with no gender preference. Imaging is crucial in the diagnosis, preoperative assessment, in staging and evaluation of treatment outcomes. Histopathology study is mandatory for the definitive diagnosis of EES among competitive differential diagnoses. The management of EES includes Surgery, chemotherapy and/or radiation therapy based on the stage of the disease. CONCLUSION: EES is a rare tumor but it should be in the differential diagnosis of adolescent patients presented with soft tissue mass/swelling.
