Musculoskeletal #23

89-year-old patient with groin mass

What do you see?

Imaging Findings

Agressive isquion mass with bone destruction, soft tissue component, necrosis and osteid matrix.

In the staging CT: Vertebral and skull signs of paget disease (Bone marrow heterogenity with lytic and sclerotic foci, cortical thikening and bone expansion; as well as partial pagetiic spinal block)

What is the most likely diagnosis?

Diagnosis

Pagetic secondary osteosarcoma on a patient with polyostotic bone paget.

Teaching Points

Osteosarcoma hallmarks are agressive bone mass with osteoid matriz.It can be primary or secondary (mainly on pagetic or radiated bone)
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