Osteosarcoma with pathological fracture

Case contributed by Dr Jeremy Jones

Presentation

Fall in play park. Left shoulder pain and reduced range of movement.

Patient Data

Age: 7
Gender: Male
Modality: X-ray

Sclerotic metaphyseal lesion with wide zone of transition, periosteal reaction and pathological fracture. Features of an aggressive lesion.

Case Discussion

A young boy presented with a painful left shoulder after a fall.

Left metaphyseal aggressive bone lesion. The differential is wide and includes osteosarcoma and Ewings. LCH should probably also sit in the differential. This does not look like infection.

A fall onto the shoulder has resulted in a pathological fracture.

Staging MR of the humerus confirmed it as a solitary lesion. Referral to the bone tumour service was made. Biopsy confirmed osteosarcoma. Chest CT confirmed multiple lung metastases.

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Case Information

rID: 6119
Case created: 1st May 2009
Last edited: 7th Feb 2017
Inclusion in quiz mode: Included

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