Femoral osteosarcoma

Case contributed by Dr Ian Bickle

Presentation

Right thigh swelling and pain.

Patient Data

Age: 14 years
Gender: Female
X-ray

Skeletally immature patient.

Permeative destructive lesion of the distal femoral diaphysis. The lesion has a wide zone of transition with periosteal reaction and a likely soft tissue component.
 

MRI

Extensive heterogeneous intramedullary marrow signal affecting the distal two thirds of the right femoral shaft. The cortex is expanded and breached in several places.

Large associated soft tissue extension 8 cm in transverse dimensions and 29 cm in longitudinal dimensions. The abnormality reaches to within 2.5 cm of the greater trochanter.  Small 1 cm focal high signal just below the intertrochanteric line, maybe a skip lesion. 

The hip joint is not involved.  

The soft tissue component abuts the neurovascular bundle in the thigh at its posterior aspect, but no definite encasement. 

 

Case Discussion

The findings are consistent with an extensive malignant mass in the right femur, likely to be an osteosarcoma, which was subsequently confirmed at surgical biopsy.

PlayAdd to Share

Case information

rID: 77789
Published: 18th Aug 2020
Last edited: 18th Aug 2020
Inclusion in quiz mode: Included

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.