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Osteosarcoma

Wirt MDW - MedPix (2001)

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Affiliation: Tripler Army Medical Center

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Plain film: An aggressive lesion of the left femoral dimetaphysis is seen with both intramedullary and cortical involvement... The lesion has a permeative appearance with starburst periosteal reaction... The profunda femoris artery becomes completely encased and non-visualized upon entry into the upper margin of the soft tissue mass... 99mTc MDP bone scan: Intense radiopharmaceutical uptake is present in the mid and distal left femur as well as in the surrounding soft tissues... Differential Diagnosis: Osteosarcoma, osteomyelitis... Discussion: Radiologic findings include an aggressive bone forming lesion which may present with a mixed presentation of bone destruction and sclerosis with an associated soft tissue mass... Codman triangles (periosteal elevation) are also frequently observed... The primary modality for further evaluation and treatment planning is MRI, where the extent of the lesion is better determined... Bone scan is useful for detecting skip lesions and distant metastasis... Additionally, scintigraphy with 201-Tl has been shown to be a good indicator of chemotheraputic response, where a reduction of radiopharmaceutical uptake in the 201-Tl-avid tumor suggests an excellent response (2-5) CT examinations are helpful for evaluation of pulmonary metastasis... Death usually results from pulmonary metastasis, however, aggressive surgical management, to include resection of all pulmonary metastasis, has improved the prognosis in this situation as long as the nodules do not abut the pleura (8).

No MeSH data available.


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Osteosarcoma

Wirt MDW - MedPix (2001)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2670&req=5

View Article: MedPix Image - MedPix Topic

Affiliation: Tripler Army Medical Center

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Plain film: An aggressive lesion of the left femoral dimetaphysis is seen with both intramedullary and cortical involvement... The lesion has a permeative appearance with starburst periosteal reaction... The profunda femoris artery becomes completely encased and non-visualized upon entry into the upper margin of the soft tissue mass... 99mTc MDP bone scan: Intense radiopharmaceutical uptake is present in the mid and distal left femur as well as in the surrounding soft tissues... Differential Diagnosis: Osteosarcoma, osteomyelitis... Discussion: Radiologic findings include an aggressive bone forming lesion which may present with a mixed presentation of bone destruction and sclerosis with an associated soft tissue mass... Codman triangles (periosteal elevation) are also frequently observed... The primary modality for further evaluation and treatment planning is MRI, where the extent of the lesion is better determined... Bone scan is useful for detecting skip lesions and distant metastasis... Additionally, scintigraphy with 201-Tl has been shown to be a good indicator of chemotheraputic response, where a reduction of radiopharmaceutical uptake in the 201-Tl-avid tumor suggests an excellent response (2-5) CT examinations are helpful for evaluation of pulmonary metastasis... Death usually results from pulmonary metastasis, however, aggressive surgical management, to include resection of all pulmonary metastasis, has improved the prognosis in this situation as long as the nodules do not abut the pleura (8).

No MeSH data available.