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Bone sarcoma arising from Paget disease

Case contributed by Matt A. Morgan
Diagnosis certain

Presentation

Chronic right leg weakness and pain. Presented to the emergency department with acute weakness.

Patient Data

Age: 50 years
Gender: Female

There is cortical and trabecular thickening of the right femur with an area of cortical breakthrough in the distal anterior femur.

Case Discussion

This patient had chronic right leg pain that had been attributed to Paget disease given the appearance of the femur and since the left femur had similar radiographic findings (although less prominent). The cortical breakthrough and acute presentation were concerning and a bone biopsy of the area in question revealed undifferentiated spindle cell sarcoma of bone.

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