Yesterday we took our 3 yr old daughter to urgent care. We noticed a few days prior a growth on her knee. It had grown a little and seemed to change the way she was walking. We have an appt with a bone specialist a couple of hours drive from us on weds. We were given a cdrom with here exam,report etc. on it. I am trying to figure out what the heck it all means, specifically the part where diagnosis of exclusion and osteosarcoma is mentioned. I just want to know what to expect as we didn't get a straight answer from the doctor we saw. See below for the content of the report.
PROCEDURE: KNEE 2 VIEWS LT
INDICATION: Painful lump, anteromedial aspect of the knee.
An abnormal mass is seen arising from the anterior aspect of the proximal tibia medially. The larger
component measuring up to 3.2 cm in craniocaudal x up to 2.4 cm AP arises from the anterior aspect of
the metaphysis adjacent to the growth plate. There is a smaller component which appears to be involving
the epiphysis centrally, measuring up to about 2 cm. This may be contiguous. The metaphyseal lesion
produces a prominent bony protuberance at the anterior aspect of the knee. Contour of this lesion is
lobulated and there is considerable increased density within both tumor sites. The appearance of the
calcification is not classic for chondroid tumor matrix and, in fact, an osteoid-producing lesion is favored.
Bones and joints are otherwise unremarkable in appearance.
Abnormal mass arising from the anteromedial aspect of the tibia at the metaphysis and probably also
involving the epiphysis. Osteosarcoma would be the diagnosis of exclusion. Chondroid lesion is
considered less likely.
Hi. A "diagnosis of exclusion" means that there is a chance that your three year old daughter's knee mass is osteosarcoma, or bone cancer. Your child's symptoms as well as the findings on MRI would fit the diagnosis of osteosarcoma. This type of cancer is prevalent in children, and occurs 80% of the time around the knee joint. However, at this point, the doctors aren't sure yet, since there are other conditions which may mimic osteosarcoma. Examples of such conditions include bone tuberculosis, and osteoma, a non-cancerous bone tumor. These other conditions have to be "excluded" by means of additional tests, before a diagnosis of osteosarcoma is finally arrived at. This additional test would probably involve a biopsy of the knee mass.
"Chondroid" means cartilage-like, and "osteoid" means bone-like. What the MRI result is saying is that the appearance of the tumor resembles bone rather than cartilage, that's why a diagnosis of osteosarcoma was considered.
My best friends' 14 yr old daughter was just diagnosed with osteosarcoma. What started out 2 wks ago as a swollen knee blamed on sliding into base, to numbness & inability to hold herself up without assistance. In the last 24 hrs, she was diagnosed with stage 4 bone cancer, a tumor on her spine & nodules in her chest. She had surgery to remove the tumor on the spine, because the doctors felt the tumor was pressing against her nerve causing the problem in her legs. We haven't yet been given a sign of hope. The news always seems to get worse & worse. The look on the doctors always look grim & we have never heard, "hang in there, things are going well." This is not my daughter, however, close in my heart since she was 3. Although we wish for complete recovery, I feel that a wheel chair is the best case scenario. Is it possible she will die?
Any feedback would be appreciated.
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