This young man was referred to the extremity tumor program at The Denver Clinic for Extremities at Risk because knee pain he was experiencing after a family vacation wasn't getting any better.  Xrays of his lower leg showed a suspicious lesion in his tibia. 

Xray and MRI showed a lesion in the proximal (upper) portion of his tibia.  He underwent a CT guided biopsy of the area and the pathology was positive for an osteosarcoma (bone cancer) of his tibia.

Xray of tibia; white arrow indicates the suspicious lesion.	MRI of left and right legs. Arrow shows the suspicious lesion.

His staging studies were negative, meaning he had no other cancerous processes such as in his lungs.  He started the intra-arterial chemotherapy protocol that The Denver Clinic physicians developed.

Arteriograms showing the blood vessels going into the tumor.  The chemotherapy is injected directly into the arteries "feeding" the tumor. As the tumor dies, the area becomes less vascular so there are fewer vessels visible in the 4th image.

After he had received four courses of chemotherapy it was determined that the tumor was at least 90% necrotic (dead) so surgical treatment was planned. This would involve removing the tumor, and area (margin) around it to be sure no tumor cells were left behind. Then the tibia bone would be reconstructed using a modular prosthesis that contained foam metal. The foam metal would provide a scaffold for new bone to form into, making the reconstruction stronger and more life-like.

	Intra-operative image after the tumor was removed.  The area of the tibia that the tumor is on is on the left. The foam metal modular prosthesis is on the right.
	Xray showing the prosthesis in place. The reconstruction required that the femur (thigh) side of the knee joint be replaced to provide good knee stability.

He is now 2 years out from his treatment for bone cancer. He remains cancer-free and is a college student at Johns Hopkins University.  Click here for a news story that aired after his reconstruction surgery.