Delayed diagnosis and cultural barriers in pediatric osteosarcoma: A case report from a low-resource setting

Background: Osteosarcoma is the most common primary malignant bone tumor in children and adolescents. Early diagnosis and treatment are critical for improving outcomes. In low-resource settings, delays in seeking appropriate medical care due to cultural beliefs and reliance on traditional medicine can contribute to disease progression and poor prognosis.

Case Presentation: We report the case of a 12-year-old girl with a six-month history of a painless, rapidly enlarging mass on her left shoulder. The patient initially sought treatment from multiple hospitals and traditional healers, receiving antibiotics, analgesics, and topical herbal treatments. The mass continued to grow, ulcerated, and was associated with systemic symptoms including fever, dizziness, and malaise. On presentation, the child was cachectic, pale, tachycardic, and unable to stand unassisted. Imaging showed findings consistent with osteosarcoma. Due to strong parental beliefs against surgical intervention, the decision for disarticulation was made only after the involvement of spiritual leaders. Surgery was successfully performed, and histopathology confirmed osteosarcoma. The patient was referred for chemotherapy; however, follow-up data remains unavailable.

Conclusion: This case highlights the impact of delayed presentation, cultural beliefs, and systemic healthcare gaps on the management of pediatric osteosarcoma. Early diagnosis, community education, and culturally sensitive care coordination are essential to improve outcomes in similar settings.