Solitary fibular metastasis from nonsmall cell lung carcinoma

Abstract

Solitary bone metastasis to fibula in patients of lung carcinoma is a rare entity, with only four cases reported in literature. We, hereby, present a case of a 50 year-old-male who was given three cycles of chemotherapy for lung carcinoma with no distant metastasis but presented 2 months later with a fusiform, painful swelling around the knee that was clinically suspected to be inflammatory in nature but proved to be fibular metastasis on cytology. There was no evidence of skeletal metastasis on initial bone scan. He was given palliative radiotherapy for this with symptomatic relief.

Keywords: Fibular metastasis; lung carcinoma; solitary fibular metastasis.

Figure 1

(a) Clinical photograph of the swelling (b) X-ray of knee joint (lateral view) shows lytic expansile lesion of the head of fibula (c) Fine needle aspiration cytology of the lesion shows clusters of malignant squamous cells (triangle) with evidence of keratinization (solid arrow) (100×) with evidence of intracytoplasmic keratinization (solid arrow, inset) (400×) (d) H and E stained section showing malignant squamous cells with hyperchromatic nuclei and dense eosinophilic cytoplasm (arrow) (H and E ×400)