Telangiectatic osteosarcoma with hemorrhagic-necrotic variant

Demographic and clinical details: 38 years old male, with a left hip pain

Image Details AP radiograph of left femur shows the mixed lytic and sclerotic one lesion located in proximal metaphysis and diaphysis of left femur. Note the thinning of proximal and thickening of distal cortex. Axial CT image shows the lytic and sclerotic regions with cortical penetrations areas. MR image shows the soft tissue extension of lesion with enhancing solid and non-enhancing cystic regions. Cortical destruction and soft tissue extension of lesion should suggest the diagnosis of malignant bone tumors. Pet CT demonstrate hypermetabolic bone tumor with multiple hypermetabolic lung metastasis. Histopathological examination confirmed the diagnosis of hemorrhagic-necrotic variant of telangiectatic osteosarcoma.

Tel-OS is a rare variant of OS (%1.2-7 of all osteosarcomas) which considered a subtype of osteosarcoma (not othervise specified).Tumors are consist of large blood-filled spaces separated by thin bony septations. Osteodi matrix mineralisation is less than conventional OS.