Osteosarcoma in Paget disease

Case contributed by Melbourne Uni Radiology Masters

Presentation

Left hip pain.

Patient Data

Age: 74-year-old
Gender: Male
CT

CT Abdomen and pelvis

Lower lumbar spine and pelvic Paget disease, left hemipelvis worse than right. In the left ilium, along the pelvic surface, enlarging enhancing soft tissue mass is again demonstrated with associated periosteal new bone formation. This has increased from 6.4 x 1.7 x 7.7 cm (2 years ago) to 7.5 x 2.4 x 9.9 cm (6 months ago) to currently 8 x 2.6 x 11 cm.

Conclusion: Enlarging soft tissue mass related to Paget disease of the left hemipelvis remains concerning for sarcomatous transformation. Metastasis is felt less likely. No other potential sites of metastatic disease.

Case Discussion

Biopsy proven osteosarcoma

Secondary development of osteosarcoma in Paget occurs in ≈1% of cases and is often highly resistant to treatment. 

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Case information

rID: 41317
Published: 26th Nov 2015
Last edited: 16th Jul 2018
Tag: rmh
Inclusion in quiz mode: Included

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