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Metastatic Osteosarcoma
Case Detail
| Anatomy: Gastrointestinal |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Neoplasia Malignant |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
CT
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Activities:  PDF  ImageJA |
History
Teenager with above the knee amputation and multiple pulmonary metastatectomies for osteosarcoma presenting for surveillance CT of the chest.
Case Images
Diagnosis
Osteosarcoma metastatic to the pancreas
Findings
Non-contrast CT of the chest suggests a noncalcified mass in the tail of the pancreas which is confirmed on post-contrast dedicated pancreatic CT. The gross pathological specimen correlates nicely with the CT imaging. Histology
demonstrated pleomorphic nuclei embedded in chondroid and osteoid matrix.
Discussion
Micrometastatic disease is usually present at the initial diagnosis of osteosarcoma. Metastatic disease in osteosarcoma is most often seen in lung (98.1%), skeleton (37.0%), pleura (33.3%), heart (20.4%), kidney and liver (16.7%), diaphragm (14.8%), mediastinum (11.1%), and lymph node (7.4%) by autopsy. There have been case reports of metastasis to the skin, dura, brain, peritoneum, muscle, bowel and bronchi; only 3 previous cases of metastasis to the pancreas reported. Unusual metastatic sites are common in patients with multiple recurrences.
Reference
-Glass RJ, et al. Osteosarcoma Metastatic to the Pancreas in Young Patients. Clinical Radiol 1996. 51(4):293-294.
-Kim SJ, et al. Imaging Findings of Extraosseous Metastases of Osteosarcoma. Clin Imaging 2004. 28(4):291-300.