Osteosarcoma of the patella: A case report

Figures & data

Figure 1. A lateral radiograph of the right knee. The right patella was enlarged, and its cortical shell was irregularly discontinued. Osteolytic and osteoblastic lesions were irregularly distributed in the patella.

Figure 2. Computed tomography showing an intraosseous osteolytic lesion and soft tissue extension at the anterior part to the patella.

Figure 3. Magnetic resonance imagines showing an intraosseous lesion extending into the anterior soft tissue. A: On T1-weighted images, the lesion showed low signal intensity. B: On T2-weighted images, the proximal part of the lesion showed low signal intensity with partial high-signal areas, and the distal part showed high signal intensity with focal low-signal areas.

Figure 4. Middle-power view of the biopsied specimens of the patella showing a proliferation of spindle-shaped atypical cells with condensation of chromatin and abundant osteoid formation (×100, hematoxylin and eosin).

Table I. Details of eight cases on osteosarcoma of the patella.

Author, year (ref)	Age/Sex	Interval^a	M0/1	Initial Tx	Biopsy	Second Tx	Associated factors	Prognosis
1. Goodwin, 1961 (11)	24/ M	6 months	0	Patellectomy	–	AKA	None	DOD
2. Nagai, 1993 (9)	34/F	7 months	M1	Steroid injection	+	Chemo + AKA	None	1 month, DOD
3. Okada, 1994 (6)	54/M	3 months	0	Chemo + patellectomy	+		Post-radiation	120 months, NED^a
4. Ferguson, 1997 (7)	18/F	NA	0	Patellectomy	–	Knee resection	Rothmund–Thomson syndrome	25 months, NED
5. Ishikawa, 2000 (8)	35/F	NA	NA	NA	NA	NA	Werner syndrome	NA
6. McGrath, 2006 (10)	53/M	3 months	M1	Steroid injection	+	Chemo + Knee resection	None	15 months, DOD
7. Cho, 2009 (12)	53/F	3 years	0	NA	+	Reconstruction after patellectomy	None	26 months, NED
8. The current case	31/F	2 years	0	NSAIDs	+	Chemo + AKA	None	48 months, AWD

^aInterval from the onset of symptoms to definitive diagnosis.

^bPersonal communication from the authors.

AKA = above-the-knee amputation; AWD = alive with disease; Chemo = systemic chemotherapy; DOD = died of disease; NA = not available; NED = no evidence of disease; NSAIDs = non-steroidal anti-inflammatory drugs; Tx = treatment.

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