Division of Orthopaedic Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
J Med Case Rep. 2024 Aug 21;18(1):385. doi: 10.1186/s13256-024-04725-7.
Telangiectatic osteosarcoma is rare and it rarely affects flat bones, especially the bones of the pelvis. It is uncommon for telangiectatic osteosarcoma to be considered as a differential diagnosis when assessing a large intrabdominal mass.
We present our case of a 33-year-old African female who presented with a sizeable telangiectatic osteosarcoma of the left iliac bone. She reported a 3-year duration of a painless, slow-growing mass arising from the left flank. At examination, a large bony hard mass extending from the left ilium to the umbilicus was noted, almost mimicking an intra-abdominal pregnancy. All laboratory tests were within normal limits and an unconventional surgical approach was used for a one-stage excision of the tumor without complications. The definitive histopathological diagnosis postexcision was that of a telangiectatic osteosarcoma only on the second review of the histological specimen.
Pelvic telangiectatic osteosarcoma is rare, and the ilium is the commonly affected pelvic bone. These tumors can be sizeable at presentation with intra-abdominal or pelvic extension with a high chance of misdiagnosis. Fortunately surrounding soft tissue involvement seems to be a rare and late finding when present.
毛细血管扩张性骨肉瘤较为罕见，且很少累及扁骨，尤其是骨盆骨。在评估巨大腹腔肿块时，将毛细血管扩张性骨肉瘤作为鉴别诊断较为少见。
我们报告了一例 33 岁的非洲女性，其左侧髂骨患有较大的毛细血管扩张性骨肉瘤。她自述 3 年前左侧腰部出现无痛性、缓慢生长的肿块。体格检查发现，从左侧髂骨延伸至脐部有一个大的骨性硬块，几乎类似于腹腔妊娠。所有实验室检查均在正常范围内，并采用非常规的手术方法进行了一期肿瘤切除，无并发症。切除后的明确组织病理学诊断仅在第二次复查组织标本时才确定为毛细血管扩张性骨肉瘤。
骨盆毛细血管扩张性骨肉瘤较为罕见，髂骨是常见的受累骨盆骨。这些肿瘤在出现时可能很大，具有腹腔内或盆腔延伸的可能性，误诊率很高。幸运的是，当出现时，周围软组织受累似乎是一种罕见且较晚的发现。
