Pathologic Fracture as Presentation of Generalized Lymphangiomatosis in an Eight-Year-Old: A Case Report and Literature Review

Abstract

Pathologic fractures commonly occur secondary to abnormal skeletal physiology in the context of benign or malignant lesions. Rarely, pathologic fractures may occur in the context of a lymphatic abnormality, such as generalized lymphangiomatosis. This rare disorder is characterized by variable presentations in a broad age range of patients. By understanding the effect of widespread lymphatic anomalies on various organ systems, clinicians will be able to make this diagnosis earlier and with more certainty.

Keywords: generalized lymphangiomatosis; lymphatics; pathologic fracture; pediatrics; radiology.

Figure 1. Pathologic fracture of the proximal right radial diaphysis with underlying lytic lesions (arrow).

Figure 2. Chest CT demonstrating large infiltrative multicompartmental mediastinal mass with cervical extension on the left and inferior extension to the esophageal hiatus, encasing mediastinal structures.

Figure 3. MRI demonstrating macrocystic infiltrative multicompartmental mediastinal mass measuring 13 × 12 × 17 cm suggestive of a lymphatic malformation.