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

Research output: Contribution to journalArticlepeer-review

Abstract

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
Volume57
Issue number1
DOIs
Publication statusPublished - 1 Feb 2012

Keywords

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

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