Open Access Case report

Small cell osteosarcoma of a toe phalanx: a case report and review of literature

Jantine PosthumaDeBoer1*, Harm CA Graat1, Johannes Bras2 and Rachid Saouti1

Author Affiliations

1 Department of Orthopaedic Surgery, VU University Medical Centre, Amsterdam., The Netherlands

2 Department of Pathology, Academic Medical Centre, Amsterdam, The Netherlands

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Journal of Orthopaedic Surgery and Research 2010, 5:36 doi:10.1186/1749-799X-5-36

Published: 3 June 2010

Abstract

This report describes the radiological and histological findings of a small cell osteosarcoma of a toe phalanx in a 38 year old man. This man presented with pain, swelling and redness of the left third toe. Medical history revealed an osteomyelitis of this toe eight years prior. Based on clinical findings and medical history the lesion was diagnosed as an osteomyelitis. However, peroperatively the lesion had a malignant aspect. Histological examination revealed a small cell osteosarcoma of the proximal phalanx.

Osteosarcoma of the foot and especially of the tubular bones is rare. Moreover small cell osteosarcoma is a rare subtype of osteosarcoma. This case demonstrates that medical history and clinical examination can be misleading. In patients with apparent bone destruction, a malignancy must always be excluded prior to treatment. It emphasises the care that should be taken in the process of formulating a diagnosis.