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FIG. 2. (A) Anteroposterior radiograph of an 18-year-old female with osteosarcoma of her distal femur. (B) Arteriogram after the initial course of preoperative chemotherapy shows the dark viable tumor area of the lesion with tortuous arching vessels and intense contrast uptake. (C) Arteriogram after the second cycle shows a reduction in overall contrast intensity, with less pooling and vessel tortuosity. (D) Third-cycle arteriogram shows a dramatic decrease in contrast uptake with little evidence of residual tumor blush. It was estimated that there was >90% decrease in neovascularity. The last cisplatin dose was administered. The patient had limb-preservation surgery consisting of wide local resection and reconstruction with a custom modular distal femoral replacement and rotating hinge knee. The tumor had >90% necrosis on final pathology. (E) Five years after resection, the patient was continuously disease free and had returned to normal activities, including competitive softball.
