Common Musculoskeletal Tumors of Childhood and Adolescence Carola A.S. Arndt, MD, Peter S. Rose, MD, Andrew L. Folpe, MD, Nadia N. Laack, MD, MS  Mayo Clinic Proceedings  Volume 87, Issue 5, Pages 475-487 (May 2012) DOI: 10.1016/j.mayocp.2012.01.015 Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 1 Top, Photomicrograph of osteosarcoma showing production of lacelike neoplastic osteoid by hyperchromatic spindle cells. Bottom, Photomicrograph of Ewing sarcoma/primitive neuroectodermal tumor consisting of a sheetlike proliferation of uniform, undifferentiated small round blue cells. Hematoxylin and eosin, magnification 200x. Mayo Clinic Proceedings 2012 87, 475-487DOI: (10.1016/j.mayocp.2012.01.015) Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 2 Top, Photomicrograph of embryonal rhabdomyosarcoma, a spindle cell sarcoma, showing a variable degree of rhabdomyoblastic differentiation in the form of “strap cells” and rounded rhabdomyoblasts. Bottom, Photomicrograph of alveolar rhabdomyosarcoma, a small blue round cell tumor with very limited rhabdomyoblastic differentiation, usually in the form of multinucleated giant cells and occasional cells with brightly eosinophilic cytoplasm. Hematoxylin and eosin, magnification 200x. Mayo Clinic Proceedings 2012 87, 475-487DOI: (10.1016/j.mayocp.2012.01.015) Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 3 Left, Anteroposterior radiograph of osteosarcoma of the distal femur showing a destructive lesion in the metadiaphysis with neoplastic osteoid formation within the associated soft tissue mass. Middle and Right, Coronal T1- and T2-weighted magnetic resonance images demonstrate the anatomic extent of marrow involvement and soft tissue mass. Mayo Clinic Proceedings 2012 87, 475-487DOI: (10.1016/j.mayocp.2012.01.015) Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 4 Left, Anteroposterior radiograph of Ewing sarcoma of the proximal humerus demonstrates a large permeative destructive lesion involving the metadiaphysis with extensive associated malignant periosteal new bone formation and large soft tissue mass laterally. Middle and Right, Coronal T1- and T2-weighted magnetic resonance images show the anatomic extent of the soft tissue mass and marrow infiltration. Mayo Clinic Proceedings 2012 87, 475-487DOI: (10.1016/j.mayocp.2012.01.015) Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions

FIGURE 5 Expandable prosthesis to maintain limb length in a growing child. Left, Radiograph obtained on presentation of a 10-year-old child with a proximal femur osteosarcoma. Right, Radiograph at 4-year follow-up shows maintenance of equal leg lengths with the use of an expandable prosthesis. Mayo Clinic Proceedings 2012 87, 475-487DOI: (10.1016/j.mayocp.2012.01.015) Copyright © 2012 Mayo Foundation for Medical Education and Research Terms and Conditions