Telangiectatic osteosarcoma

Case contributed by Yasser Asiri
Diagnosis almost certain


Enlarging mid thigh mass.

Patient Data

Age: 18 years
Gender: Male

An aggressive bone lesion in the femoral diaphysis with wide zone of transition and associated lamellated periosteal reaction. The mass has osteoid matrix and causes subtle permeative bone destruction. Adjacent large soft tissue mass is seen. No pathological fracture seen. 


Redemonstration of the distal femoral diaphyseal aggressive lesion with bone destruction and soft tissue component. The lesion contains regions of fluid-fluid levels as well as areas of high signal intensity in T2 and T1 weighted images indicating hemorrhage. Peripheral enhancement is noted post Gadolinium administration. 

The mass is invading the vastus medialis and intermedius as well as the adductor muscles. There is mass effect on the adjacent neurovascular bundle with resultant posteromedial displacement.  There is significant perilesional edema.  No skip lesions. 

Case Discussion

Telangiectatic osteosarcoma is a rare form of osteosarcoma and usually presents with aggressive lytic lesion and doesn't produce osteoid matrix on radiograph. On MRI, there will be multiple solid-enhancing components and fluid-fluid levels within the mass with areas of high T1 signal intensity. The histopathology reports confirmed the diagnosis. 

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