Telangiectatic osteosarcoma of the spine: a case report

Abstract

Telangiectatic osteosarcoma (TOS) of the spine is rare accounting for only 0.08% of all primary osteosarcomas. Though a well described radio-pathological entity it is not often thought of as a cause of paraplegia. We describe the clinical, radiological and pathological features and discuss the treatment options of telangiectatic osteosarcoma of the dorsal spine presenting in a young man. The diagnostic pitfalls are discussed emphasising the fact that the diagnosis of TOS of the spine requires not only a multi modal approach of appropriate radiological and pathological tests but also an awareness of this condition.

 Telangiectatic osteosarcoma: a review of literature

“…Scattered, markedly pleomorphic tumor cells with hyperchromatic, mitotically-active nuclei were present; in foci, lace-like osteoid admixed with tumor cells and reactive new bone was seen, and a diagnosis of TO was finally made. The patient was advised palliative chemotherapy and radiotherapy 19. Another case of spine TO with the involvement of cervical vertebrae has been reported by Turel et al2 The patient presented with a 6-month history of neck pain and torticollis.…”

“…Amritanand et al19 described a rare case of TO of the thoracic spine leading to paraplegia. The patient complained of back pain for 3 months and subsequently developed weakness and numbness of both lower limbs, which over a period of 1 week progressed to complete paraplegia with loss of bowel and bladder function.…”

Primary telangiectatic osteosarcoma of the cervical spine

“…20 There have been very few case reports discussing the management of spinal TOS, and the outcome has generally been dismal. 1,12 The anatomical peculiarity of the spine makes it difficult to achieve an oncological resection. Murakami et al 12 described 2 patients with TOS of the thoracic spine and total paraplegia who underwent a total spondylectomy with complete resection of the spinal cord (and preoperative chemotherapy in 1 case).…”

Analysis of a Preliminary microRNA Expression Signature in a Human Telangiectatic Osteogenic Sarcoma Cancer Cell Line

“…The most common location at TOS presentation is the metaphyses of long bones and, in particular, the proximal tibia (16.9%) and distal femur (41.6%) [ 9 , 10 , 11 , 12 ]. However, TOS can also occur in atypical locations for OS, such as craniofacial bones, jaw, mandible, vertebrae, and soft tissues [ 13 , 14 , 15 , 16 , 17 ]. TOS of the soft tissues is a rare extraskeletal OS, characterized by the production of osteoid matrix at soft tissue levels, without any attachment to bone or periosteum.…”

“…Nevertheless, the survival rate at five years is poor because of local recurrences or distant metastases (i.e., lung metastasis), which are very common in case of the presence of metastases at diagnosis [ 27 , 28 ]. At the same time, all case reports regarding extraosseous TOS of soft tissues and TOS of unusual locations (i.e., jaw, mandible, spine or skull) present poor prognosis given that, in these cases, surgery is often impossible, and the patients present recurrences or lung metastases [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”