title: [Secondary telangiectatic osteosarcoma of the left femur. A case presentation of an unusual course of disease].
abstract: BACKGROUND
  This article presents the unusual case of a 73-year-old male patient who was treated with primary interlocking nailing after a pathological femoral fracture.
  
  
  METHODS
  Despite comprehensive diagnostics including several biopsies, a tumor could not be detected. In 2008 when progressive cystic femoral destruction leading to loosening of the nail necessitated a partial femoral prosthesis, an osteosarcoma could first be diagnosed in the resected bone.
  
  
  METHODS
  Advanced progression of the tumor required an extended hip exarticulation. During the current restaging of the now 84-year-old patient no tumor could be detected.
  
  
  CONCLUSIONS
  When a malignancy cannot be excluded even by repeated biopsies of radiologically suspicious structures, an adequate tumor staging followed by close monitoring should be carried out. For a clinically silent, long-term course of cystic destruction of a long bone over several years, an age over 60 years and a lack of distant metastases, an atypical osteosarcoma should be considered in the differential diagnosis.
authors.affiliation: Klinik für Orthopädie, Unfall- und Plastische Chirurgie, Universitätsklinikum Leipzig, Liebigstr. 20, 04103, Leipzig, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Zajonz
authors.forename: M
authors.initials: M
authors.lastname: Werner
authors.forename: S
authors.initials: S
authors.lastname: Panzert
authors.forename: A S
authors.initials: AS
authors.lastname: Strübing
authors.forename: S
authors.initials: S
authors.lastname: Tiepolt
authors.forename: E
authors.initials: E
authors.lastname: Fabsits
authors.forename: P
authors.initials: P
authors.lastname: Brandmaier
authors.forename: C-E
authors.initials: CE
authors.lastname: Heyde
authors.forename: T
authors.initials: T
authors.lastname: Prietzel
mesh_terms: D000368:Aged; D005188:False Negative Reactions; D005266:Femoral Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000601:surgery*; D012516:Osteosarcoma / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome
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