What is the most likely diagnosis for a 15-year-old adolescent presenting with two months of pain and swelling in the left leg, without any history of trauma, and radiologic findings showing periosteal reaction with onion skin appearance and radiating spicules in the fibula?

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Diagnóstico Diferencial Para el caso presentado, se consideran las siguientes opciones diagnósticas:

  • Diagnóstico más probable
  • Sarcoma de Ewing: La presencia de dolor y tumefacción en la pierna izquierda durante dos meses, sin antecedentes traumáticos, junto con los hallazgos radiológicos de reacción perióstica en forma de escamas de cebolla y espículas radiadas desde el córtex óseo en forma de púas de peine, son características típicas del Sarcoma de Ewing, especialmente en adolescentes.
  • Otros diagnósticos probables
  • Osteosarcoma: Aunque es menos probable que el Sarcoma de Ewing, el Osteosarcoma también puede presentar con dolor y tumefacción en los huesos largos, incluyendo el peroné, y puede mostrar patrones radiológicos similares.
  • Sarcoma periostea: Este tipo de tumor óseo también puede presentar con reacción perióstica y espículas radiadas, aunque es menos común que el Sarcoma de Ewing y el Osteosarcoma.
  • No debes perder de vista (diagnósticos potencialmente mortales si se pasan por alto)
  • Fibrosarcoma: Aunque es un tumor óseo menos común, el Fibrosarcoma puede presentar con síntomas y hallazgos radiológicos similares a los del Sarcoma de Ewing y el Osteosarcoma, y su diagnóstico oportuno es crucial para el tratamiento y el pronóstico.
  • Diagnósticos raros
  • Otras neoplasias óseas: Como el condrosarcoma, el osteocondroma, o el tumor de células gigantes, que pueden presentar con síntomas y hallazgos radiológicos similares, aunque son mucho menos comunes en esta edad y con estos hallazgos radiológicos específicos.

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