Osteosarcoma of the Talus Treated Successfully with Limb-Sparing Surgery
A Case Report
Hirohisa Katagiri, MD, PhD; Mitsuru Takahashi, MD, PhD; Tatsuya Takagi, MD, PhD; Masahiro Nakagawa, MD, PhD

Except for multiple myeloma, osteosarcoma is the most common primary malignant bone tumor. It typically affects the metaphyseal part of the long bones, with the knee being affected in almost 50% of cases1. Osteosarcoma of the foot is rare, and almost half of the reported cases in the foot were found to have arisen from the calcaneus2,3. Osteosarcoma of the talus is very rare; to the best of our knowledge there are only two previous case reports in the literature4,5. Patients with osteosarcoma of the foot are usually not good candidates for limb-sparing surgery. To our knowledge, all patients with osteosarcoma of the talus who have been reported in the literature were managed with below-the-knee amputation2-5. We report the first case of a patient in whom osteosarcoma of the talus was successfully treated with limb-sparing surgery with ankle arthrodesis. The patient was informed that data concerning the case would be submitted for publication, and he consented.

Case Report

A forty-nine-year-old man presented with a one-year history of pain in the right ankle and no history of any traumatic causative event. Physical examination revealed a slight but diffuse swelling in the right ankle, which was painful with movement and during weight-bearing. All laboratory data, including the serum alkaline phosphatase level, were within normal limits. A plain radiograph demonstrated an ill-defined lucent lesion with cloudy mineralization from the head of the talus to the anterior one-third of the body of the talus (Fig. 1).

Fig. 1

Lateral plain radiograph showing an ill-defined osteolytic lesion with cloudy mineralization. The lesion extends from the talar head to the anterior one-third of the talar body.

A T1-weighted sagittal magnetic resonance image (Fig. 2, A) revealed a lesion that had low signal intensity and that …

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