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ISRN Oncology
Volume 2013 (2013), Article ID 219369, 6 pages
http://dx.doi.org/10.1155/2013/219369
Clinical Study

Osteosarcoma in Adult Patients Living with HIV/AIDS

Tumour, Sepsis and Reconstruction Unit, Grey’s Hospital, Townbush Road, Pietermaritzburg 3201, KwaZulu-Natal, South Africa

Received 4 February 2013; Accepted 21 February 2013

Academic Editors: A. Berner and E. Sueoka

Copyright © 2013 Leonard C. Marais and Nando Ferreira. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. HIV infection has reached epidemic proportions in South Africa, with an estimated prevalence of 21.5% in adults living in the province of KwaZulu-Natal. Several malignancies have been identified as part of the spectrum of immunosuppression-related manifestations of HIV infection. Very few reports, however, exist regarding the occurrence of non-AIDS-defining sarcomas in the extremities or limb girdles. Methods. A retrospective review was performed on all adult patients, between the ages of 30 and 60 years, with histologically confirmed osteosarcomas of the appendicular skeleton referred to a tertiary-level orthopaedic oncology unit. Results. Five out of the nine patients (62.5%) included in the study were found to be HIV positive. The average CD4 count of these patients was 278 (237–301) cells/mm3, indicating advanced immunological compromise. Three of the malignancies in HIV-positive patients occurred in preexisting benign or low-grade tumours. Conclusion. A heightened index of suspicion is required in HIV patients presenting with unexplained bone and joint pain or swelling. Judicious use of appropriate radiological investigation, including magnetic resonance imaging of suspicious lesions and timely referral to an appropriate specialized orthopaedic oncology unit, is recommended.