Case contributed by Mohammad Osama Hussein Yonso
Diagnosis certain


Painful mass in the lower part of the left femur.

Patient Data

Age: 12 years
Gender: Male

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


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

The most important differential considerations include :

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.