PMC3929053_01
(a) Normal X-ray chest (b) X-ray left lower limb showing radiolucent mass in the mid shaft with extensive calcification (c and d) MRI scan showing well defined lobulated mass with infiltration in the medullary cavity
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F1
X-ray was normal [Figure 1a]. X-ray of the affected lower limb revealed large lucent defect in the medullary cavity in the mid shaft, with extensive calcification/ossification in the soft tissue mass [Figure 1b]. Magnetic resonance imaging (MRI) scan revealed a well defined lobulated mass with infiltration in the medullary cavity suggestive of a malignant neoplastic lesion, possibly osteosarcoma [Figure 1c and d].
Photomicrograph showing (a) Malignant spindle shaped cells (b) Osteoid with pleomorphic cells (c) Large areas of hemorrhage with endothelial lined vascular areas and neoplastic cells (d) Chondroblastic areas (H&E, x100)
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F2
Areas with islands of malignant round cells were also seen [Figures 2 and 3].
Photomicrograph showing (a) Vascular spaces arranged in stag horn pattern and spindle shaped cell arranged around it in hemangiopericytomatous pattern (H&E, x100) (b) Osteoid with large pleomorphic cells (H&E, x400) (c) Malignant small round cell pattern (H&E, x400) (d) Fibroblastic areas (H&E, x400)
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F3
Areas with islands of malignant round cells were also seen [Figures 2 and 3].