Telangiectatic osteosarcoma: radiologic-pathologic comparison.
OBJECTIVE
To describe the imaging characteristics of a large series of telangiectatic osteosarcomas with pathologic findings for comparison.


METHODS
The authors retrospectively reviewed 40 pathologically confirmed telangiectatic osteosarcomas. Patient demographics and images from radiography (n = 36), bone scintigraphy (n = 17), angiography (n = 4), computed tomography (CT) (n = 25), and magnetic resonance (MR) imaging (n = 27) were evaluated by three authors in consensus for lesion location, size, and intrinsic characteristics. There were 27 men (68%) and 13 women (32%) in the study, with an age range of 4-83 years (mean age, 24 years).


RESULTS
Lesions frequently affected the femur, tibia, and humerus. Radiographs showed geographic bone lysis, a wide zone of transition, and matrix mineralization. CT demonstrated low attenuation, MR demonstrated high signal intensity on T2-weighted images, and both demonstrated hemorrhage, which simulated the appearance of aneurysmal bone cyst. Viable sarcomatous tissue surrounding hemorrhagic and/or necrotic regions was best seen at contrast material-enhanced CT and MR imaging, with thick peripheral, septal, and nodular enhancement in all cases. Subtle matrix mineralization in this viable tissue was best seen at CT. An associated soft-tissue mass was also seen in 19 of 25 cases (76%) at CT and in 24 of 27 cases (89%) at MR imaging.


CONCLUSIONS
CT and MR imaging findings of telangiectatic osteosarcoma often include thick nodular tissue (and matrix mineralization at CT) in a largely hemorrhagic and/or necrotic osseous lesion with an associated soft-tissue mass, which allows distinction from aneurysmal bone cyst.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis; D001859:Bone Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D001842:Bone and Bones / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012516:Osteosarcoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013684:Telangiectasis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed