Multifocal primary bone sarcoma in the elderly: a rare case and review of the literature

A D Duckworth, I Beggs, D M Salter, J T Patton, D E Porter

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To our knowledge there are no reports of a primary multifocal spindle cell sarcoma affecting both long bones of the lower limb in an elderly patient. An 83-year-old man presented with a progressively painful right ankle, without a history of trauma. Radiographs demonstrated a pathological fracture through a mixed lytic and sclerotic lesion in the distal tibia. Staging investigations, including bone scintigraphy and magnetic resonance imaging, revealed a second lytic lesion in the right distal femur. A provisional diagnosis of metastatic disease was favoured and intramedullary nailing was considered. However, computed tomography of the chest, abdomen and pelvis, and relevant blood tests revealed no evidence of a primary malignancy. Open biopsy of the tibial lesion showed high-grade pleomorphic spindle cells consistent with a primary bone sarcoma. The patient was treated successfully with a right trans-femoral amputation. In conclusion, we recommend early bone biopsy to allow accurate diagnosis and appropriate skeletal management in elderly patients.
Original languageEnglish
JournalScottish Medical Journal
Issue number1
Publication statusPublished - 1 Feb 2012


  • multifocal spindle cell sarcoma
  • sarcoma
  • metastases
  • elderly
  • pathological fracture

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