Telangiectatic Osteosarcoma

  • Imaging:
    — Location: metaphyseal, femur
    — Lytic or blastic: lytic
    — Matrix: osteoid
    — Zone of transition: (wide, narrow)
    — Periosteal new bone or cortical destruction: aggressive disrupted periosteal reaction with Codman’s triangle, permeative cortical destruction
    — Additionally: large extraosseous mass with osteoid matrix, skip lesions, fluid-fluid levels, cystic / necrotic / hemorrhagic, asymmetric expansion, minimal peripheral sclerosis
  • DDX: aneurysmal bone cyst, telangiectatic osteosarcoma has enhancing nodules / osteoid matrix / extraosseous soft tissue mass
  • Clinical: 5% of osteosarcoma

Radiology Cases of Telangiectatic Osteosarcoma

Radiograph of telangiectatic osteosarcoma of femur
AP (left) and lateral (right) radiographs of the knee show a metaphyseal lesion that is lytic in appearance with an osseous matrix and a wide zone of transition and a Codman’s triangle of periosteal reaction with associated cortical destruction. On the lateral image there is a suggestion of an associated soft tissue mass posteriorly.