Twenty-five patients who had an osteosarcoma of the pelvis were treated
at the University of Florida between 1967 and 1990. Two of these patients
had underlying Paget disease, and five had received previous radiation
therapy to the pelvis. Common problems in this series of patients included
delays and errors in establishment of the diagnosis, underestimation of the
extent of the tumor on the radiographic staging studies, histopathological
findings of local extension next to and into pelvic structures, widespread
invasion into major pelvic veins, and microscopic foci of tumor in
otherwise normal tissue. These problems led to difficulty in gaining local
control of the tumor with any type of operative procedure. Of the eighteen
patients who had a resection, only four had a contamination-free wide
margin, and a local recurrence developed in thirteen. Only one patient, who
had no evidence of disease eleven years after treatment, was alive at the
time of writing. Because of the tendency for venous invasion, the
radiographic staging studies should include a thorough evaluation of the
blood vessels adjacent to the tumor.