Fracture Neck of the Femur: A Case of Two Pathologies

Mohamed H. Ahmed, Shravani Joshi, Amirmohammad Heidari, Oliver Pearce, Maria Panourgia, Henry Owles, Moez Dungarwalla

Abstract


We report a case of a 65-year-old woman who sustained a left neck of femur (NOF) fracture following low-energy trauma. Computed tomography (CT) scan for the neck, chest, abdomen and pelvis was normal apart from enlargement of the right lobe of the thyroid. Interestingly, thyroid function was normal. While waiting for the result of thyroid cytology and bone histology, the patient recovered well from the operation and started to engage well with physiotherapy. The result of the investigation showed presence of diffuse large B-cell lymphoma in the left NOF and right lobe of the thyroid. As the presence of lymphoma only in these two organs is extremely rare, it is not yet clear what is underlying mechanism for such association. Therefore, such observations may raise many future research questions as detailed in the discussion of this case report. This case also illustrates the importance of a multidisciplinary approach in identifying, evaluating, and treating unique and complex presentations of NOF fracture, with a focus on the patients history, clinical examination and applying diagnostic tools.




J Med Cases. 2023;14(3):95-99
doi: https://doi.org/10.14740/jmc4055

Keywords


Neck of femur fracture; Neck of femur malignancies; Malignancy; Clinical examination; Multidisciplinary team

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