Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma
Antalgic gait is a common clinical presentation among pediatric patients and can have many different etiologies, with rare life-threatening etiologies including primary bone malignancies. Osteosarcoma is the most common primary malignancy of bone in pediatric and adolescent patients. The incidence r...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2021/5531238 |
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| author | Michael DePalma Sachin Gupta Jie Nguyen Divya Talwar Alexandre Arkader Lawrence Wells |
| author_facet | Michael DePalma Sachin Gupta Jie Nguyen Divya Talwar Alexandre Arkader Lawrence Wells |
| author_sort | Michael DePalma |
| collection | DOAJ |
| description | Antalgic gait is a common clinical presentation among pediatric patients and can have many different etiologies, with rare life-threatening etiologies including primary bone malignancies. Osteosarcoma is the most common primary malignancy of bone in pediatric and adolescent patients. The incidence rate of osteosarcoma has been reported as high as 5 to 7 per million among patients 19 years old or younger with males slightly more affected than females and African-Americans more than other racial groups. This report describes the case of a five-year-old African-American female who presented with an antalgic gait secondary to osteosarcoma in the left distal femur and follows her through treatment. In this case, the age is atypical as the peak incidence for osteosarcoma is around 16 years of age and is postulated to coincide with growth spurts. Osteosarcoma can have a range of presentations making it difficult to diagnose, which can cause delays in treatment and potential poor patient outcomes. Due to this, such a diagnosis must be included in the differential for patients presenting with antalgic gait. Because primary-care physicians and pediatricians may be the first medical providers to encounter patients with osteosarcoma, it is imperative that such clinicians are familiar with the signs and symptoms associated with osteosarcomas in order to reduce the risk of metastasis and disease progression and prevent treatment delays. Additionally, we believe these clinicians should have a low threshold to refer patients to orthopedists or oncologic specialists in the cases of persistent pain or inconsistencies with history, physical exam, and diagnostic studies. Finally, direct communication and discussion between radiologists and referring clinicians helps decrease delays in diagnosing of osteosarcoma and other life-threatening conditions. |
| format | Article |
| id | doaj-art-f8423ababfd64a8297bed99ba4fa8601 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-f8423ababfd64a8297bed99ba4fa86012025-02-03T00:58:59ZengWileyCase Reports in Pediatrics2090-68032090-68112021-01-01202110.1155/2021/55312385531238Do Not Miss the Tumor: A Novel Presentation of OsteosarcomaMichael DePalma0Sachin Gupta1Jie Nguyen2Divya Talwar3Alexandre Arkader4Lawrence Wells5Children’s Hospital of Philadelphia, Philadelphia, PA, USAChildren’s Hospital of Philadelphia, Philadelphia, PA, USAChildren’s Hospital of Philadelphia, Philadelphia, PA, USAChildren’s Hospital of Philadelphia, Philadelphia, PA, USAChildren’s Hospital of Philadelphia, Philadelphia, PA, USAChildren’s Hospital of Philadelphia, Philadelphia, PA, USAAntalgic gait is a common clinical presentation among pediatric patients and can have many different etiologies, with rare life-threatening etiologies including primary bone malignancies. Osteosarcoma is the most common primary malignancy of bone in pediatric and adolescent patients. The incidence rate of osteosarcoma has been reported as high as 5 to 7 per million among patients 19 years old or younger with males slightly more affected than females and African-Americans more than other racial groups. This report describes the case of a five-year-old African-American female who presented with an antalgic gait secondary to osteosarcoma in the left distal femur and follows her through treatment. In this case, the age is atypical as the peak incidence for osteosarcoma is around 16 years of age and is postulated to coincide with growth spurts. Osteosarcoma can have a range of presentations making it difficult to diagnose, which can cause delays in treatment and potential poor patient outcomes. Due to this, such a diagnosis must be included in the differential for patients presenting with antalgic gait. Because primary-care physicians and pediatricians may be the first medical providers to encounter patients with osteosarcoma, it is imperative that such clinicians are familiar with the signs and symptoms associated with osteosarcomas in order to reduce the risk of metastasis and disease progression and prevent treatment delays. Additionally, we believe these clinicians should have a low threshold to refer patients to orthopedists or oncologic specialists in the cases of persistent pain or inconsistencies with history, physical exam, and diagnostic studies. Finally, direct communication and discussion between radiologists and referring clinicians helps decrease delays in diagnosing of osteosarcoma and other life-threatening conditions.http://dx.doi.org/10.1155/2021/5531238 |
| spellingShingle | Michael DePalma Sachin Gupta Jie Nguyen Divya Talwar Alexandre Arkader Lawrence Wells Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma Case Reports in Pediatrics |
| title | Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma |
| title_full | Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma |
| title_fullStr | Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma |
| title_full_unstemmed | Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma |
| title_short | Do Not Miss the Tumor: A Novel Presentation of Osteosarcoma |
| title_sort | do not miss the tumor a novel presentation of osteosarcoma |
| url | http://dx.doi.org/10.1155/2021/5531238 |
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