Giant osteosarcoma of Femur: A well documented case with difficulties in the management in Yaoundé (Cameroon)

Abstract

Osteosarcomas are primary malignant bone tumours in which mesenchymal cells produce an osteoid matrix. It is generally the most common malignant bone neoplasm. The purpose of this article was to present the difficulties bound to the management of an osteosarcoma of the thighbone in Yaounde. A 49-year-old woman referred to the University Hospital Center of Yaounde for further management of the complete and large deformation of the right thigh. A biopsy realized 14 years rather concluded in an osteoma. The patient had refused an amputation proposed 5 years after this first diagnosis, in spite of the loss of shape of the limb. The main clinical findings were hard swelling and large deformation of the right thigh. Review of the X-ray revealed multiples larges and lytic expansible lesions of third lower femur. A microscopic analysis of the specimens stemming from the part of amputation showed areas of osteoid formation surrounded by hyper cellular stroma, confirming the diagnosis of osteoblastic osteosarcoma. The patient was then recommended for oncologic treatment. It thus seems clearly that in the absence of multidisciplinary confrontation, the management is not only delayed and extended but burdens considerably the prognosis of patients.