EURORAD ESR

Case 105

Teleangectatic osteosarcoma of the proximal femur: radiologic and pathologic correlations

Author(s)
E. Bassetti, M. Mastantuono, F. Manganaro, F. Trenta
 
Patient
female, 31 year(s)
 
 
  • Figure 1
    Conventional X-Ray of the pelvic girdle. A-P projection.

    At the level of the proximal metaphisis of the right femur is present an osteolitich lesion, disomogeneous with a multilacunar aspect extending to the femural head.

     
    Area of Interest: unknown; Imaging Technique: Conventional X-Ray of the pelvic girdle. A-P projection.;
     
     
  • Figure 2
    MRI Examination. Sagittal T1 and T2 “weighted” images.
     

    Presence of a neoplastic mass localizzed at the level of the femural metaphisis extending cranio-caudally for at least 70 mm. The mass presents a low and disomogeneous signal intensity. There is a thinning of the...

     
    Area of Interest: unknown; Imaging Technique: MRI Examination. Sagittal T1 and T2 “weighted” images.;

    High signal intensity of the lesion in the T2 “weighted” image suggesting an high cellularity and vascularization of the lesion.

     
    Area of Interest: unknown; Imaging Technique: MRI Examination. Sagittal T1 and T2 “weighted” images.;
     
     
  • Figure 3
    MRI Examination. Axial T2 “weighted”images.
     

    Evidentiation of the multilacunar spaces at the level of the femural head that had an high signal intensity.

     
    Area of Interest: unknown; Imaging Technique: MRI Examination. Axial T2 “weighted”images.;

    In this image is well depicted the invasion of the periskeletal soft tissues posteriorly.

     
    Area of Interest: unknown; Imaging Technique: MRI Examination. Axial T2 “weighted”images.;
     
     
  • Figure 4
    MRI
     

    Presence of a low signal intensity mass localizzed at the level of the femural metaphisis with irregular margins.

     
    Area of Interest: unknown; Imaging Technique: MRI;

    High enhancement of the skeletal mass and of the periskeletal soft tissues after the administration of contrast medium. There is not an enhancement of the lacunar spaces after the administration Gd-DTPA

     
    Area of Interest: unknown; Imaging Technique: MRI;
     
     
  • Figure 5
    Gross specimen

    The surgical specimen was the proximal third of the right femur with the nearest soft tissues and was of 14 cm in lenght on the cut surface and was present a neoplasm of 11 cm in diameter reddish and brownish in...

     
    Area of Interest: unknown; Imaging Technique: Gross specimen;
     
     
  • Figure 6
    Histologic examination

    Histologic examination was consistent with a neoplasm made up by spindle-shaped cells with moderate atipia and focal haemangiopericytoma-like growth pattern. In some areas osteoid like material appears to be present....

     
    Area of Interest: unknown; Imaging Technique: Histologic examination;
     
     
At the level of the proximal metaphisis of the right femur is present an osteolitich lesion, disomogeneous with a multilacunar aspect extending to the femural head.
 
Presence of a neoplastic mass localizzed at the level of the femural metaphisis extending cranio-caudally for at least 70 mm. The mass presents a low and disomogeneous signal intensity. There is a thinning of the bone cortex.
 
High signal intensity of the lesion in the T2 “weighted” image suggesting an high cellularity and vascularization of the lesion.
 
Evidentiation of the multilacunar spaces at the level of the femural head that had an high signal intensity.
 
In this image is well depicted the invasion of the periskeletal soft tissues posteriorly.
 
Presence of a low signal intensity mass localizzed at the level of the femural metaphisis with irregular margins.
 
High enhancement of the skeletal mass and of the periskeletal soft tissues after the administration of contrast medium. There is not an enhancement of the lacunar spaces after the administration Gd-DTPA
 
The surgical specimen was the proximal third of the right femur with the nearest soft tissues and was of 14 cm in lenght on the cut surface and was present a neoplasm of 11 cm in diameter reddish and brownish in color, with irregular margins and destroying the femoral head. There was a break through og the cortex with soft tissues mass.
 
Histologic examination was consistent with a neoplasm made up by spindle-shaped cells with moderate atipia and focal haemangiopericytoma-like growth pattern. In some areas osteoid like material appears to be present. The mytotic index was hight while necrosis extensive. Vascular infiltration was noted. Neoplastic cells were S-100 and vimentine positive, myoglobina, smooth muscle actine, desmin and CD 34 negative.
 
 
 
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