What do you see?
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?
Pagetic secondary osteosarcoma on a patient with polyostotic bone paget.
Osteosarcoma hallmarks are agressive bone mass with osteoid matriz.It can be primary or secondary (mainly on pagetic or radiated bone)