22556              OSTEOGENIC SARCOMA

The patient was a man aged 49 with longstanding Paget's disease. A painful mass on the left thigh resulted in the limb being removed proximal to the area of induration.

The specimen consists of the entire left leg of an adult male. The thigh shows antero-posterior and lateral bowing and there is an old oblique healed surgical incision running diagonally across the anterior surface of the thigh from within, outwards and downwards. This incision measures 20 cms in length. The upper 6 cms is an old white scar and the lower two thirds of the incision is a more recent scar. A thin plastic catheter protrudes from a stab wound lateral to the lower end of this surgical incision. The knee appears normal as does the foot. There is slight thickening and bowing of the tibia. Section shows advanced sclerotic Paget's disease of the femur, and a large blood-filled cavity anterior to the shaft. Histology showed in one section mostly blood clot and fibrin, and one small piece of Paget bone. Large pleomorphic cells with large hyperchromatic nuclei were scattered throughout and there were occasional small irregular multi-nucleated cells. A second section showed more cellular sarcomatous tissue with some osteoid formation and many tumour giant cells.