Presentation
An adolescent with a lower limb mass.
Patient Data
There is an aggressive lytic lesion in the distal metaphysis of femur. Soft tissue swelling is noted. There are sparse areas of ossification in the tumor matrix.
There is a multiloculated lytic lesion in the distal metaphysis of the femur. Multiple fluid-fluid levels are seen in the lesion. Massive edema is seen in the muscular compartments. Bone marrow edema involves the epiphysis. Multiple hemorrhagic areas are seen in the T1WI.
The findings are consistent with telangiectatic osteosarcoma.
Case Discussion
Telangiectatic osteosarcoma is an uncommon variant of osteosarcoma that consists of multiple blood-filled cavities. The location and age-distribution of the lesion are like conventional osteosarcoma.
On plain x-ray, the lesion appears as a lytic destructive lesion with minor amounts of matrix mineralization or periosteal reaction.
On MRI the lesion contains multiple cysts filled with blood with multiple fluid-fluid level areas. These findings are not specific and might be seen in giant cell tumors or aneurysmal bone cysts.
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