TAILIEUCHUNG - PosthumaDeBoer et al. Journal of Orthopaedic Surgery and Research 2010, 5:36

PosthumaDeBoer et al. Journal of Orthopaedic Surgery and Research 2010, 5:36 CASE REPORT Case report Open Access Small cell osteosarcoma of a toe phalanx: a case report and review of literature Jantine PosthumaDeBoer*1, Harm CA Graat1, Johannes Bras2 and Rachid Saouti1 Abstract This report describes the radiological and histological findings of a small cell osteosarcoma of a toe phalanx in a 38 year old man. This man presented with pain, swelling and redness of the left third toe. Medical history revealed an osteomyelitis of this toe eight years prior. Based on clinical findings and medical history the lesion was diagnosed as an osteomyelitis. However, peroperatively. | PosthumaDeBoer et al. Journal of Orthopaedic Surgery and Research 2010 5 36 http content 5 1 36 éHMÌ JOURNAL OF ORTHOPAEDIC oo SURGERY AND RESEARCH CASE REPORT Open Access Small cell osteosarcoma of a toe phalanx a case report and review of literature Jantine PosthumaDeBoer 1 Harm CA Graat1 Johannes Bras2 and Rachid Saouti1 Abstract This report describes the radiological and histological findings of a small cell osteosarcoma of a toe phalanx in a 38 year old man. This man presented with pain swelling and redness of the left third toe. Medical history revealed an osteomyelitis of this toe eight years prior. Based on clinical findings and medical history the lesion was diagnosed as an osteomyelitis. However peroperatively the lesion had a malignant aspect. Histological examination revealed a small cell osteosarcoma of the proximal phalanx. Osteosarcoma of the foot and especially of the tubular bones is rare. Moreover small cell osteosarcoma is a rare subtype of osteosarcoma. This case demonstrates that medical history and clinical examination can be misleading. In patients with apparent bone destruction a malignancy must always be excluded prior to treatment. It emphasises the care that should be taken in the process of formulating a diagnosis. Background Osteosarcoma OS is the most common primary malignant bone tumor in children and adolescents with a peak incidence at age 15-19 years old. Typically it originates from the metaphysis of long bones and has a high tendency to systemic spread 1 . Osteosarcoma of short tubular bones is a rarity 2-5 . An osteosarcoma of a toe phalanx was first ever described by Mirra et al in 1988 6 7 . Since then only a few cases have been reported. Osteosarcoma in the foot represents approximately 0 5 of all osteosarcomas 1 3 . As opposed to conventional osteosarcoma it is more often encountered in adult patients 4 8 . A higher percentage of osteosarcoma of tubular bones is found to be low grade thus less aggressive

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