Pathology quiz: Small cell ostosarcoma

A 15-year-old black male presented with shortness of breath, leg weakness, and pain in his back and rib cage. Four years previously he had noticed a l ump in his upper back and complained of pain when playing basketball, espec ially on contact to that area. Recently, the pain had become more constant and increased in intensity. This was associated with loss of control in his legs, weakness, and parathesia. General physical examination revealed a pa lpable mass in the right midline upper back. Laboratory results were within normal limits. Radiographic scans demonstrated a destructive soft tissue a t T6 vertebral body with scattered stippled calcification (Figure 1). The p atient underwent a biopsy followed by excision of the mass (Figure 2) and d ecompressive laminectomy with reconstruction.