Missing the Malignancy in Primary Care: A Case Study on Pediatric Osteosarcoma

Area of Science:

• Pediatric Oncology
• Orthopedic Surgery
• Diagnostic Radiology

Background:

• Osteosarcoma is the most common primary malignant bone tumor in children and adolescents.
• Symptoms like localized bone pain are often nonspecific and attributed to benign conditions, leading to diagnostic delays.
• Primary care providers face challenges in differentiating osteosarcoma from common pediatric complaints.

Purpose of the Study:

• To examine a case of osteosarcoma in a 14-year-old female with initially misdiagnosed persistent leg pain.
• To highlight the diagnostic challenges and consequences of delayed diagnosis in pediatric osteosarcoma.
• To emphasize the need for enhanced clinical awareness and diagnostic protocols in primary care settings.

Main Methods:

• Case study analysis of a 14-year-old female patient with persistent leg pain.
• Review of initial primary care presentation, diagnostic imaging, and subsequent advanced imaging and biopsy.
• Evaluation of factors contributing to delayed diagnosis.

Main Results:

• The patient's osteosarcoma was initially misdiagnosed due to nonspecific symptoms and normal initial evaluations.
• Worsening symptoms and neurological deficits prompted further investigation, leading to a confirmed diagnosis.
• Diagnostic delay occurred despite initial presentation in a primary care setting.

Conclusions:

• This case underscores the critical need for increased clinical suspicion and awareness of osteosarcoma in pediatric patients presenting with unexplained, unilateral bone pain.
• Standardized diagnostic guidelines and structured follow-up protocols are essential to mitigate diagnostic delays in primary care.
• Early and accurate diagnosis of pediatric osteosarcoma is vital for timely intervention and improved patient outcomes.