Myoepithelial tumor of the bone: radiologic and histopathologic correlation

Myoepithelial tumors of the bone (BMET) are rare and diagnostically challenging due to their nonspecific clinical and radiologic features. Herein, we report the case of a 19-year-old patient who presented with progressive left hip pain for 1 year. Pelvic radiography revealed an expansile osteolytic lesion of the left iliac bone, abutting the articular surface of the left sacroiliac joint. Cross-sectional imaging demonstrated an aggressive expansile mass with cortical destruction and adjacent soft tissue involvement, raising concern for a primary malignant bone tumor. Imaging differential diagnoses included Ewing sarcoma, chondrosarcoma, and other round cell neoplasms. Image-guided biopsy and histopathological analysis confirmed a BMET. This case highlights the importance of recognizing the radiographic appearance of this rare entity and the role of multimodality imaging and histopathologic correlation in establishing the diagnosis of atypical pelvic lesions in young patients.