Clinical image description

A 17-year-old man complaining of aggressive and painful mass at the left thigh was admitted. Examination displayed the patient was in dreadfully pale complexion, with poor vitality and nutrition (166 cm in height, and 43 kg in body weight). A huge globose soft neoplasm (35 cm in diameter) was located above the knee joint, accompanied by engorged vein, tension blister and partially necrotic crust on its surface. Blood test showed he was in serious cachexia (29 g/L of hemoglobin and 23 g/L of albumin). The x-ray showed pathological fracture, extensive osteoblastic destruction, and a soft tissue mass at the distal metaphysis of the left femur. A needle aspiration biopsy and a histological examination confirmed the diagnosis of osteosarcoma. The patient asked for amputation but the myocutaneous condition was not available. He was transferred to receive neoadjuvant chemotherapy for a possible surgical opportunity. Actually the patient was diagnosed as early osteosarcoma one year ago but he refused any treatment, which predicts a worse prognosis.

Figure 1: Patient image showing ostesarcoma.

Declarations

Acknowledgement: This study was supported by Innovative technology in military and clinical medicine (2018JSLC0035), Technological Innovation and Application Demonstration Project of Chongqing [cstc2022jscx-msyb0541], National and Chongqing continuing medical education programs.

Disclosure: None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article.

Conflict of interest statement: All of the authors confirm that there is no conflict of interest.