Oncology Expert Witness Opines on Delayed Diagnosis of Chondrosarcoma That Led to Increased Morbidity

Case Overview

This case involves a forty-year-old patient with a past medical history of inactive hepatitis B and hypothyroidism by Synthroid. The patient presented to the treating physician with complaints of pain on her left hip, which she experienced after she had been lying on her side sun-bathing. The patient was able to palpate a bony growth approximately half the size of her thumb on her pelvis. The treating physician reported in her treatment records that the patient’s abdomen was soft, non-tender, with no masses or hepatosplenomegaly and normal bowel sounds. The physician also reported that there was a small mass between the pelvic bone and skin which she diagnosed tentatively as a lipoma. The patient was told that inconsequential and no follow-up was ordered. Over the next several weeks, the pain gradually increased and the mass felt significantly larger. Appearing to her to extend into her abdomen. The patient was examined by a primary care physician at another medical facility 76 days after the initial consultation. On physical examination of the abdomen, a large abdominopelvic mass in the left lower quadrant was found and a CT scan was ordered. The CT scan revealed a probable osteosarcoma measuring approximately 10 cm transversely, 8 cm anteroposteriorly, and 15.5 cm sagittally. There was no evidence of metastases or lymphadenopathy. The patient underwent a left sub-total iliac bone resection to remove the tumor. Based on biopsy samples taken during the procedure, it was felt that the chondrosarcoma most likely arose from pre-existent sessile osteochondroma. The patient was left with a large scar from the surgery and an antalgic gait due to paresthesia in her left thigh. She was no longer able to maintain her previous levels of physical activity.