Chronic Recurrent Multifocal Osteomyelitis Mimicking Osteosarcoma.

Area of Science:

• Pediatric oncology
• Rheumatology
• Orthopedic surgery

Background:

• Metastatic osteosarcoma and chronic recurrent multifocal osteomyelitis (CRMO) present similar clinical and imaging findings in adolescents.
• Diagnostic delays can occur when CRMO is not considered early in the differential diagnosis.

Observation:

• An adolescent female initially suspected of having metastatic osteosarcoma was diagnosed with CRMO after extensive evaluation.
• The initial presentation included clinical and imaging findings highly suggestive of malignancy.

Findings:

• The case highlights the challenge in differentiating CRMO from osteosarcoma based on initial assessments.
• Percutaneous biopsy samples may be insufficient for definitive diagnosis of CRMO, especially when neoplasm is also suspected.

Implications:

• Considering CRMO earlier can streamline diagnostic workups and accelerate treatment initiation.
• In cases where both CRMO and neoplasm are diagnostic possibilities, open surgical biopsy may be the preferred method for accurate diagnosis.