BONE PATHOLOGY CASE STUDIES

CASE 1 - Osteosarcoma of bone

Clinical History:

This is an 18 year old male with a six-month history of progressive pain in his left distal thigh. He had some moderate swelling about his knee. His pain was worse at night. He did not have pain with ambulation. Radiographs demonstrated an osteoblastic lesion of the distal femur). (Slide 1.1)
  1. What is the diagnosis?

    2. A typical osteosarcoma is present. The hard white areas seen grossly are areas of osteoid matrix microscopically. The tumor is composed of anaplastic spindle cells typical of a sarcoma. Metastases from such a lesion would probably be hematogenously spread.

  2. In whom and at what sites is this lesion most common?

    3. There is a slight male predominance, with peak incidence from teenage to young adulthood. The most common sites are around the knee.

  3. Can you name a possible environmental cause for such a lesion? Where are such lesions going to be seen soon?

    4. There are some radiation-induced osteosarcomas. Following the Chernobyl nuclear accident, Strontium-90 was released and got into soil, then into grass, was eaten by cows, and cows' milk was ingested by kids, who are now at risk (from Kiev to Helsinki) for osteosarcoma. Bone trauma IS NOT a cause for sarcomas.