PED Case 8: Osteosarcoma metastases
Publication Date: 20170629
Patient is a 14-year-old male with history of left tibia osteosarcoma (diagnosed 2 ½ years ago) status post above the left knee amputation. He had a relapse 10 months ago, with known metastases to lung and spine, status post debulking and laminectomy, ICE chemotherapy and radiation therapy to lumbosacral spine. At a recent hematology visit he had a chest x-ray for cough and rhinorrea which revealed a pneumothorax.
• Metastasis: most likely given the appearance of the lesion (multiple round nodules, rapidly enlarging).
• Other differential possible, given atypical time course (rapid enlargement in a month).
– Fungal infection
– TB infection
– Granulomatosis with polyangitis
• Osteosarcoma metastases often ossify and favor the lung. Classically known to cause pneumothorax
• Most common pediatric primary malignancy with pulmonary metastasies:
– Wilm’s tumor
– Ewing’s sarcoma
- Core Radiology