Twenty-three patients with subacute or chronic osteomyelitis in whom the differential diagnosis between osteomyelitis and bone tumor was difficult were selected for presentation from a group of patients seen at Mayo Clinic between 1953 and 1972. Two thirds of the patients were in the younger age groups, and two thirds of the lesions were in the long bones of the lower extremities. The most common tumor suspected was Ewing sarcoma, followed by osteogenic sarcoma. Other suspected neoplasms were reticulum cell sarcoma, leukemia, osteoid osteoma, benign cyst, and chondromyxoid fibroma. Seven illustrative cases are presented. The best clinical method for establishing the correct diagnosis was the taking and retaking of a careful history. Treatment should never be instituted without a biopsy examination that includes an adequate amount of periosteum, cortical bone, and medullary tissue. A needle biopsy examination may not provide these.
Cabanela ME, Sim FH, Beabout JW, Dahlin DC. Osteomyelitis Appearing as NeoplasmsA Diagnostic Problem. Arch Surg. 1974;109(1):68-72. doi:10.1001/archsurg.1974.01360010050012