Osteosarcoma

Case contributed by Dr Mohammad Osama Hussein Yonso

Presentation

Painful mass in the lower part of left femur.

Patient Data

Age: 12 years
Gender: Male
X-ray

There is a bone tumor with wide zone of transition, matrix ossification and aggressive periosteal reaction (Codman triangle - arrow), at the distal of left femur.

Pathology

Osteoblastic osteosarcoma: Malignant cells producing osteoid (dense, pink, amorphous intercellular material) is the histological hallmark of osteosarcoma.

Courtesy of Dr Mohammad Adib Houreih, Department of Pathology, Tishreen University, Lattakia, Syria

Case Discussion

The radiographic findings in this 12 year old patient are compatible with osteosarcoma.

Osteosarcoma is the second most common primary bone tumor after multiple myeloma:

  • primary osteosarcoma: typically occurs in young patients (10-20 years) with 75% occurring before the age of 20
  • secondary osteosarcoma: occurs in the elderly, usually secondary to malignant degeneration of Paget disease, extensive bone infarcts or post radiotherapy for other conditions

Most important differential considerations include :

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