Xrays of the right femur demonstrate periosteal reaction with star burst appearance. Radiation oncologysarcomaosteosarcoma wikibooks, open. This material may not otherwise be downloaded, copied, printed. A rare case of osteosarcoma of the proximal fibula. Osteosarcoma is a primary malignant bone tumor, which typically affects the metaphyseal growth plates in the femur, tibia, and humerus. Histologically, cells have abundant clear cytoplasm embedded in a loose hyaline cartilaginous matrix and an infiltrative growth pattern.
To our knowledge, this case represents only the sixteenth. Eleven lesions were in the femur and 7 in the tibia. Osteosarcoma is a primary malignant tumour of the skeleton characterised by the direct formation of immature bone or osteoid tissue by the tumour cells. Early diagnosis of osteosarcoma in elderly patients is difficult, and. This case demonstrates relatively typical appearances of a bone forming osteosarcoma of the distal femur typical location in a 17yearold typi. Specifically, it is an aggressive malignant neoplasm that arises from primitive transformed cells of mesenchymal origin and thus a sarcoma and that exhibits osteoblastic differentiation and produces malignant osteoid osteosarcoma is the most common histological form of primary bone cancer. The large or giant dog breeds are those almost exclusively predisposed to the disease and the mean age of affected animals is 8 years.
Relative contraindications would include situations in which the patient is so frail that the risks of general anesthesia outweigh any potential benefits of surgery. The top of the upper arm bone humerus is another common place it grows. In jos, the average age of onset is 10 to 20 years. Oct 18, 20 intraoperatively, no obvious soft tissue infiltration was evident. Jan 23, 2007 osteosarcoma is a primary malignant tumour of the skeleton characterised by the direct formation of immature bone or osteoid tissue by the tumour cells. Remarkable advances have occurred in the management of this cancer over the last two decades. In this retrospective clinical study, 7 cases of parosteal osteosarcoma of the bone. Radiology pathological correlation of osteosarcoma in a tertiary care hospital a retrospective study p kannan1, m johnraj suresh2, heber anandan3 1professor and head, department of pathology, thoothukudi medical college, thoothukudi, tamil nadu, india, 2assistant professor. They are the second most common primary bone tumor after multiple myeloma, accounting. Abstract osteosarcoma os is a relatively rare tumor of bone with a worldwide incidence of 3. The duration of symptoms preceding a definitive diagnosis of osteosarcoma is quite long. An anteroposterior view of a distal femur osteosarcoma showing sclerosis of the metaphysis and ossification of a soft tissue mass with a wide zone of transition and. The multidisciplinary treatment of osteosarcoma of the proximal tibia. An anteroposterior view of a distal femur osteosarcoma showing sclerosis of the.
Mri of osteosarcoma of distal femur same patient roll over the images for more information. The hypoechoic soft tissue mass with bony spicules within is seen involving the distal end of the right femur. Apr 10, 2018 after 10ish weeks of chemo, the treatment plan calls for a limb salvage surgery. Linear echogenic areas are seen within this soft tissue mass representing bony spicules. In this case, the diagnosis of radiationinduced osteosarcoma allowed. The cancer most often grows in the ends of long bones, especially the bottom of the thigh bone femur and the top of the larger shin bone tibia. Initial treatment was by resection of the primary tumour with adjuvant chemotherapy. Osteosarcoma osteogenic sarcoma orphanet journal of. There are numerous types of primary osteosarcoma, including intramedullary high grade, telangiectatic, low grade, small cell, osteosarcomatosis, and gnathic, surface intracortical, parosteal, periosteal, and highgrade surface, and extraskeletal. Feb 22, 2017 osteosarcoma is the most common primary bone maliganncy in the pediatric population. The current standard of care for distal femoral osteosarcoma is neoadjuvant chemotherapy followed by limb salvage for the surgically. Lowgrade central osteosarcoma of distal femur, resembling. In this text experts in the field discuss the most pertinent biologic and clinical issues relevant to the disease.
Because osteosarcoma is a deadly form of cancer, no absolute contraindications for treatment exist. These lesions are found on the metaphyseal regions of long bones, typically the distal femur, and have a stuck on appearance. The histological examination of the excised specimen revealed central lowgrade osteosarcoma. The bones around the knee are the most commonly affected. A boy, aged 14 years, sustained a fracture of the midshaft of the femur. Histological examination of the excised specimen revealed central lowgrade osteosarcoma. Radiology pathological correlation of osteosarcoma in a. Osteosarcoma osteogenic sarcoma in children health. Tratamiento del osteosarcoma e histiocitoma fibroso. Osteosarcoma is the eighth most common form of childhood cancer, comprising 2. This was treated conservatively and healed in weeks. An osteosarcoma os or osteogenic sarcoma ogs or simply bone cancer is a cancerous tumor in a bone. The proximal fibula is a very rare site for osteosarcoma, and in mayo series, reported incidence was only 2%. Pediatric and adolescent osteosarcoma springerlink.
One year later an osteosarcoma developed at the site of the healed fracture. Mark gebhardt, md and kristy weber, md also available in chinese, japanese and spanish. The treatment of osteosarcoma requires a multidisciplinary approach. Pdf osteosarcoma is a malignant tumor that primarily affects the long bones but can also involve other bones in the body. Evidence of malignant osteoid bone andor cartilage formation with destructive lesions and sclerosis is characteristic of the disease. They are the second most common primary bone tumor after multiple myeloma, accounting for 20% of all primary bone tumors. Osteosarcoma arises predominantly in the long bones and rarely in the soft tissues.
A 25yearold male was diagnosed in 2004 as a femur osteosarcoma with no evidence of distance metastases. Although several case reports have been published on osteosarcoma of the femur, to the best of our knowledge this report is the first one with such an unusual clinical course. July, 2002 distal femur resection with endoprosthetic reconstruction 227 border and ligaments and menisci are removed. Osteosarcoma is the most common primary bone malignancy. The most common type of osteosarcoma is the primary, high grade, intramedullary conventional osteosarcoma, which represents approximately 75% of all osteosarcomas definitions. Osteosarcoma is the most common primary bone maliganncy in the pediatric population. Distal femur resection with endoprosthetic reconstruction. We describe the case of a 58yearold caucasian man who. Teenagers who are active in sports often complain of pain in the lower femur. Review of osteosarcoma and current management springerlink. Pathological radiological signs are often evident by the time of diagnosis. Until clearly proven otherwise, a bone forming tumour in this. A destructive process with lytic areas and sclerosis is. Tratamiento del osteosarcoma e histiocitoma fibroso maligno.
Another relative contraindication would be a situation in which the patient has extensive, overwhelming metastatic disease, and. Diagnostic and treatment problems with parosteal osteosarcoma. Parosteal osteosarcoma pos is a slowgrowing tumor which originates from the outer layer of the periosteum and represents 65% of surface osteosarcomas and in our database accounts approximately for 4, 8% of all osteosarcomas. Osteosarcoma is the most common histological form of primary bone cancer. This paper discusses a rare case of renal metastatic osteosarcoma. Learn about the risk factors for osteosarcoma and if there are things that might help lower risk. Osteosarcoma is a disease that mainly affects the long bones of the op296 pdf body and. There is evidence of cortical disruption at multiple places. The team approach to osteosarcoma of the distal femur in an. The most frequent sites of origin are the distal femur, proximal tibia and.
An anteroposterior view of a distal femur osteosarcoma showing sclerosis of. These are examples of the gross pathology specimens of resected conventional osteosarcoma, consisting of both bony and soft tissue areas. Characteristics and prognostic factors of osteosarcoma of. Dec 04, 2018 because osteosarcoma is a deadly form of cancer, no absolute contraindications for treatment exist. It has a predilection for the knee area with 50% of cases in either the distal femur or proximal tibia, with the second most common site being the proximal humerus 10%. The animals were assessed in terms of age, sex, breed, topographic tumor distribution, and presence of. Radiationinduced osteosarcoma following treatment of ewings. Osteosarcoma of proximal femur usually arises at the metaphysis and articular cartilage acts as a relative barrier to tumour spread, with extension into the hip joint being extremely rare. Osteosarcoma osteosarcomas are malignant bone forming tumors. F increased bone metabolism at the distal end of the left femur. Collectively, the metaphysis of the lower long bones, specifically the distal femur and proximal tibia, are the most commonly involved primary sites. Osteosarcoma malignant tumor characterized by production of osteoid by malignant cells.
Osteosarcoma may also occur as a secondary lesion in association with underlying benign conditions. Although open biopsy suggested fibrous dysplasia, clinical and radiological evaluation indicated malignancy. Since his tumour doesnt affect his entire femur, they will keep his hip joint and proximal upper femur in tact. In general, 3 to 4 cm beyond the point of proximal tumor extension is appropriate. Osteosarcoma in the distal femur two years after an.
Osteosarcoma is the most common type of cancer affecting the bone and involves abnormal osteoblast cells that are responsible for the construction of bone. Pdf osteosarcoma os is a relatively rare tumor of bone with a worldwide incidence. Proximal and total femur resection with endoprosthetic reconstruction pdf version. Osteosarcoma most often starts in the bones around the. Get an overview of osteosarcoma and the latest key statistics in the us. Feb 04, 2012 highly malignant tumor of mesenchymal origin. They typically involve the proximal portion of femur, tibia or humerus. Comparative transverse views of the lower ends of the femorae description. We report two cases mimicking an osteochondroma, radiologically and histologically and propose an explanation. After 10ish weeks of chemo, the treatment plan calls for a limb salvage surgery. Osteosarcoma is the most common primary bone malignancy that is considered for limb salvage, although there are other types of bone cancer. They can be classified into primary and secondary forms, as well as histologic types, of which conventional osteosarcoma is the most common. Osteosarcoma following a fractured shaft of femur springerlink. Mark gebhardt, md y kristy weber, md traducido al espanol por.
A hypoechoic soft tissue mass is seen in close proximity to the lower end of the femur. Osteosarcoma is the name given to a heterogeneous group of malignant spindle cell tumors that have as their common feature the production of immature bone, also known as osteoid. Osteosarcoma is a malignant primary cancer of long bones. An osteosarcoma os or osteogenic sarcoma ogs or simply bone cancer is a cancerous. We report a case of a 32 yearold male, admitted for a lytic lesion of the distal femur. Focal cortical thinning of the posterolateral femur with a large surrounding t1. Several risk factors for the development of osteosarcoma are well established. Distal femur osteotomy is done at the appropriate location as determined by the preoperative imaging studies fig 1.
Osteosarcoma osteogenic sarcoma orphanet journal of rare. Wed like to understand how you use our websites in order to improve them. Osteosarcoma occurring in the jaws is rare, constituting only 6% to 7% of all osteosarcomas. Osteosarcoma is the most common primary malignant tumour of bone and commonly involved sites are the distal femur, proximal tibia, and humerus. One year later an osteosarcoma developed at the site of the healed.
Standard anteroposterior radiograph of the right hip. The distal femur is a far more frequently affected site compared to the diaphyseal femur. Pdf osteosarcoma os is a relatively rare tumor of bone with a worldwide. That is when they will take most of his femur out, send it to pathology and they see how well his tumour has responded to the chemotherapy. Treatment options using limb salvage or amputation physicians who treat bone cancer are called orthopaedic oncologists. The other leading differential consideration is ewing. In terms of size, the lesion in the distal femur of our patient had progressed much more than the lesions in the fracture fragments figure figure5b. Find out how osteosarcoma is tested for, diagnosed. Parosteal osteosarcoma is a welldifferentiated variant of osteosarcoma that affects the surface of the bone.
A 25yearold man with a history of metastatic osteosarcoma involving his right kidney was referred to our institution for treatment. We identified 11 parosteal osteosarcoma six of them were dedifferentiated, 3 periosteal osteosarcoma and. This produces the sunray appearance of the mass, which is highly suggestive of osteosarcoma. Osteosarcoma definition of osteosarcoma by medical. The next most common place is in the humerus, the upper arm. Eary jf, mankoff da 1998 tumor metabolic rates in sarcoma using fdg pet. Specifically, it is an aggressive malignant neoplasm that arises from primitive transformed cells of mesenchymal origin and thus a sarcoma and that exhibits osteoblastic differentiation and produces malignant osteoid. The classic or socalled conventional osteosarcoma develops in the medullary cavity of the metaphysis of long bones.