PMC3823388_01
70-year-old male with mild left hip pain and elevated alkaline phosphatase diagnosed with radiogenic osteosarcoma. (a) The planar whole body images of the technetium-99m methylene diphosphonate bone scan demonstrates intense diffuse uptake extending from the left femoral head to the proximal shaft of the femur (double ended arrow). (b) The plain film of the left hip depicts three previously unreported fixation screws surrounded by osteopenic lesions (arrow) in the femoral neck and head.
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F1
Tc-99m MDP bone scan. The planar whole body images [Figure 1a] of the Tc-99m MDP bone scan demonstrated intense diffuse uptake extending from the left femoral head to the proximal shaft of the femur. To confirm the initial diagnosis, the patient was sent directly for an X-ray [Figure 1b]. Surrounding the screws were poorly defined osteopenic, potentially lytic lesions in the femoral neck and femoral head [Figure 1b].
70-year-old male with mild left hip pain and elevated alkaline phosphatase diagnosed with radiogenic osteosarcoma. (a and b) Computed tomography of the pelvis reveal mixed lytic/sclerotic lesions (arrows) within the native bone, although evaluation of the left hip was limited due to streak artifact as seen on the two axial slices in Figure 1.
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F2
Evaluation of the scan of the left hip was limited due to streak artifact from the screws; however, it was still possible to appreciate some mixed lytic/sclerotic changes in the native bone [Figure 2a and b].
70-year-old male with mild left hip pain and elevated alkaline phosphatase diagnosed with radiogenic osteosarcoma. Histologic examination of the curettage (using Hematoxylin and Eosin stain, x10) reveals sarcomatous, spindle shaped cells (white arrows) with adjacent tumor osteoid production (black arrows); represented by eosinophilic, amorphous, fibrillary deposits (white arrows) between individual or small aggregates of tumor cells (black arrows).
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F3
Histologic study of the biopsy [Figure 3] demonstrated sarcomatous, spindle shaped cells with adjacent tumor osteoid production; represented by eosinophilic, amorphous, fibrillary deposits between individual or small aggregates of tumor cells.