Osteosarcoma on hallux

Leah Claydon · May 29, 2009

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I'd like to share this case with you.

55 year old Turkish Cypriot woman in good health presented in clinic complaining of a painful growth on her hallux, duration 1 year. She had previously been treated by two different dermatologists - one treated it as a wart, prescribing Salicylic Acid preparatons, the other treated it as a fungal infection prescribing topical terbinafine.

The lesion felt firm to the touch and did not look typical of a wart lesion. Plain x-ray revealed an small boney growth inside the lesion that was not connectd to the distal phalanx. The vascularity of the lesion worried me so I referred the patient for biopsy. Histopathology report revealed osteosarcoma. She was referred for sugery whereon her hallux was amputated.

Does anyone have any experience of osteosarcoma in a digit?

Leah
Etik Hospital, Nicosia
Turkis Republic of North Cyprus

drsarbes · May 29, 2009

Hi Leah:
Thanks for sharing this.
Do you happen to have the radiograph?

Steve

Leah Claydon · May 29, 2009

Sadly, we have a dinosaur of a x-ray machine and it's not possible to transfer the image.

If it helps, it looked about the size of a Smartie/M&M with a fuzzy halo around it - more of a 'star nebula' than a solid circumscribed mass.

Leah

NewsBot · Dec 6, 2012

Osteosarcoma of the hands and feet: a distinct clinico-pathological subgroup.
Anninga JK, Picci P, Fiocco M, Kroon HM, Vanel D, Alberghini M, Gelderblom H, Hogendoorn PC.
Virchows Arch. 2012 Dec 5.

Osteosarcomas of hands or feet are rare, and seemingly these cases differ in presentation and behavior compared to those in usual locations. The clinico-pathological presentation of patients with osteosarcomas of the hand or foot was studied and compared with published cases. Forty osteosarcomas were identified among 4,221 cases, representing 0.95 % of all osteosarcomas. Thirty of these were well documented. Mean age at diagnosis was 43 years (hands) and 36 years (feet) and male-female ratio was 1.2:1 and 2.0:1, respectively. In the hand, 62 % of the osteosarcomas presented in the metacarpals and 23 % in the phalanges, and only two cases occurred in the carpal bones. Distribution in the foot was tarsal bones 56 %, metatarsal bones 33 %, and phalanges 11 %.Of the cases in the hand 54 % were of high grade and of those in the foot 71 %. Survival of osteosarcomas of the hand or foot was 81 %. Only patients with high-grade osteosarcoma died of the disease. Histological grade was the only significant variable related to survival. High-grade osteosarcoma of the hand or feet should be treated similar to those in conventional sites. Osteosarcomas of hands or feet are rare and in a relative high proportion are of low grade. Survival in high-grade cases is comparable to that in conventional sites.
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Admin2 · Dec 6, 2012

Osteosarcoma

Cancerous tumour in a bone

Medical condition

An osteosarcoma (OS) or osteogenic sarcoma (OGS) (or simply bone cancer) is a cancerous tumor in a bone. Specifically, it is an aggressive malignant neoplasm that arises from primitive transformed cells of mesenchymal origin (and thus a sarcoma) and that exhibits osteoblastic differentiation and produces malignant osteoid.^[1]
Osteosarcoma is the most common histological form of primary bone sarcoma.^[2] It is most prevalent in teenagers and young adults.^[3]

^ Luetke A, Meyers PA, Lewis A, Juergens H (2014). "Osteosarcoma treatment—where do we stand? A state of the art review". Cancer Treat Rev. 40 (4): 523–532. doi:10.1016/j.ctrv.2013.11.006. PMID 24345772.

^ Ottaviani G, Jaffe N (2009). "The Epidemiology of Osteosarcoma". Pediatric and Adolescent Osteosarcoma. Cancer Treatment and Research. Vol. 152. New York: Springer. pp. 3–13. doi:10.1007/978-1-4419-0284-9_1. ISBN 978-1-4419-0283-2. PMID 20213383.

^ "Osteosarcoma". US National Library of Medicine. PubMed Health. 2013.

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Paul Bowles · Dec 7, 2012

Osteochondroma would have been my first thought based on the fact you usually find osteosarcomas in long bones but since it looks terrible your decision was obviously correct and well and truly warranted. Well done!

NewsBot · Apr 2, 2019

Calcaneal Osteosarcoma in a Patient Referred for Plantar Heel Pain
Journal of Orthopaedic & Sports Physical Therapy, 2019 Volume:49 Issue:4 Pages:285–285

A 28-year-old man was referred to physical therapy from his primary care provider with variable and intermittent left lateral plantar heel pain that began insidiously about 10 months prior. Radiographs of the foot and ankle were completed prior to the physical therapy evaluation and interpreted as noncontributory. Because his pain and function were minimally improved after 4 weeks, the patient was referred for magnetic resonance imaging. An abnormal mass in the calcaneus prompted an urgent referral to an orthopaedic oncologist. Percutaneous biopsy confirmed a diagnosis of calcaneal osteogenic sarcoma.
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Osteosarcoma

Paul Bowles Well-Known Member

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