Telangiectatic Osteosarcoma Clinical Presentation

Updated: May 01, 2018
  • Author: Nirag C Jhala, MD, MBBS; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Presentation

History and Physical Examination

The clinical presentation of telangiectatic osteosarcoma closely resembles that of conventional osteosarcoma. However, local pain, soft-tissue masses, and fractures are the most common presenting symptoms and signs. [6, 17, 18, 19]

Telangiectatic osteosarcoma lesions are usually osseous, but extraosseous lesions have been reported. In the long bones, these tumors usually occur in the metaphyseal region within the medullary cavity. As the tumors expand and destroy the cortex, blowout fractures may occur. These lesions may also occur in a diaphyseal location. [20]

The distribution pattern of telangiectatic osteosarcomas in the long bones is as follows [15] :

  • Distal femur - 48%
  • Proximal humerus - 12%
  • Proximal tibia - 10%
  • Proximal femur - 8%
  • Fibula - 5%
  • Midfemur - 2%
  • Midhumerus - 2%

These tumors have also been known to occur in the mandible [21, 22]  and, rarely, the rib. [23]

Potentially, telangiectatic osteosarcomas can arise in bones involved with Paget disease, [24, 25] where it can mimic other forms of conventional osteosarcoma. [26]

Telangiectatic osteosarcomatous differentiation has been reported in parosteal osteosarcoma, [27] in dedifferentiated chondrosarcoma arising in the background of osteochondroma, [28] in association with aneurysmal bone cysts, [29, 30, 31] and in osteitis deformans.

Telangiectatic osteosarcoma also has been noted to arise in extraosseous soft tissues in the forearm, thigh, and popliteal fossa. [32] Although rare, telangiectatic osteosarcomatous differentiation has been seen in cases of malignant phyllodes tumor of the breast [33] and in cases of ovarian sarcoma. [34]