Nl. Harris et al., OSTEOGENIC-SARCOMA ARISING FROM BONY REGENERATE FOLLOWING ILIZAROV FEMORAL LENGTHENING THROUGH FIBROUS DYSPLASIA, Journal of pediatric orthopedics, 14(1), 1994, pp. 123-129
Sarcomatous degeneration of fibrous dysplasia has been previously docu
mented in rare cases, often in association with prior radiation therap
y. This case report describes the occurrence of osteosarcoma arising i
n the distal femur of a 15-year-old male with previous biopsy-proven f
ibrous dysplasia, who had undergone limb lengthening through a distal
femoral corticotomy using the technique described by Ilizarov. In addi
tion, distraction osteogenesis through an area of fibrous dysplasia in
the proximal tibia produced a new area of fibrous dysplasia in the re
generate tissue as shown by histopathologic examination. This case rai
ses two questions: (a) whether the biologic stimulus of distraction os
teogenesis through abnormal metaplastic bone increases the risk of mal
ignant neoplasia, and (b) whether distraction osteogenesis through dys
plastic bone is contraindicated, since the regenerate tissue does not
form normal bone.