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Title: Een 14-jarige jongen met een pijnlijke knie
Author(s): DE CONINCK T, GEERTS B, DHOOGE C, SYS G, VERSTRAETE K
Journal: Tijdschrift voor Geneeskunde
Volume: 68    Issue: 18   Date: 2012   
Pages: 892-895
DOI: 10.2143/TVG.68.18.2001257

Abstract :
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A 14-year-old boy with knee pain
The medical history of a 14-year-old boy who presented with a painful left knee and hobbling, is discussed. Clinical examination revealed restricted knee flexion. Plain radiography was performed, revealing the classic signs of a malignant bone tumor.
Subsequently, an MRI (magnetic resonance imaging) was performed. The bone and soft tissue involvement was suggestive for an osteosarcoma. No skip lesions were found. General staging revealed no metastases. A biopsy was performed and the diagnosis of high-grade osteosarcoma was confirmed.
Primary osteosarcoma represents the most common malignant primary bone tumor. It is most frequently seen in the knee, with a peak incidence in puberty. MRI is a non-invasive technique for local staging, follow-up of the chemotherapy and prediction of the prognosis.
The treatment protocol consists of three months of neoadjuvant chemotherapy, resection of the tumor with limb-sparing surgery and eight months of adjuvant chemotherapy. The prognosis amounts to 50% to 75% of a five-year survival, depending on the response to the chemotherapy.

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