Talar Osteosarcoma in an Elderly Woman

Abstract not available. Introduction provided instead.

Although second only to myeloma as the most common primary malignant bone tumor, osteosarcoma is an uncommon diagnosis in foot and ankle pathology, particularly in elderly patients. In the United States, osteosarcoma is still considered a relatively rare disease, with approximately 600 cases diagnosed each
year.¹ The distal femur and proximal tibia are the most common sites for osteosarcoma, representing 50% of all cases.² Osteosarcoma of the foot and ankle accounts for only 0.2% to 2.0% of all cases of osteosarcoma.³

Early presentation of osteosarcoma of the foot and ankle may include pain, swelling, mechanical symptoms with ambulation, difficulty wearing shoes, and sometimes a palpable mass.^4,5 The subtle clinical presentation combined with the uncommon occurrence of osteosarcoma of the foot and ankle may lower the index of suspicion and delay diagnosis in many cases. Radiographic imaging may be helpful, but there is a marked variety in the radiographic appearance of osteosarcoma of the foot and ankle. Treatment usually includes below-knee amputation and sometimes chemotherapy. As osteosarcoma of the foot and
ankle is rare, information regarding prognosis is limited. However, previous reports suggest the estimated 5-year survival rate ranges from 35% to 75%.^6,7

We present the case of an 81-year-old woman diagnosed with a primary high-grade osteoblastic osteosarcoma of the talus.