Low-grade intramedullary osteosarcoma presenting with multiple sclerotic bone lesions

Area of Science:

• Orthopedic Oncology
• Radiology
• Pathology

Background:

• Low-grade intramedullary osteosarcoma is a rare, indolent subtype of osteosarcoma.
• Delayed diagnosis is a frequent challenge due to its subtle presentation.

Observation:

• A 42-year-old woman presented with persistent low back pain.
• Multiple imaging studies and biopsies were required for definitive diagnosis.
• The hallmark radiologic finding was diffuse skeletal involvement with sclerotic lesions, particularly evident on bone scintigraphy.

Findings:

• The case illustrates the diagnostic complexities associated with low-grade intramedullary osteosarcoma.
• Skeletal scintigraphy proved crucial in identifying the widespread nature of the lesions.

Implications:

• Highlights the importance of considering rare diagnoses in cases of persistent, unexplained pain.
• Underscores the need for comprehensive radiologic assessment and multidisciplinary diagnostic approaches.
• Emphasizes the diagnostic challenges posed by low-grade intramedullary osteosarcoma, necessitating increased awareness among clinicians.