Pulmonary metastasised extraskeletal osteosarcoma

A 63- year-old Caucasian man who smoked presented with lower back pain, dyspnoea and weight loss. A chest CT showed multiple bilateral cavitating lesions, consolidations and ground glass lesions (figure 1). Because a CT-guided pulmonary biopsy elsewhere revealed chronic inflammation with caseating granulomas, he had initially been treated with tuberculostatics and subsequently antifungal medication without clinical improvement. Since the patient had also developed a lesion in the neck, this was biopsied and revealed an undifferentiated round cell tumour. Subsequently, a video-assisted thoracoscopy was performed. Pathological analysis demonstrated metastasis of an osteosarcoma; therefore, the final diagnosis was metastasised extraskeletal small cell osteosarcoma (figure 2). Despite treatment with radiotherapy for bone metastasis and doxorubicin-based chemotherapy, he died a few months later. Extraskeletal osteosarcomas are high-grade mesenchymal soft tissue malignancies accounting for 1% of all soft tissue sarcomas and approximately 2–4% of all osteosarcomas. By definition,...
Source: Thorax - Category: Respiratory Medicine Authors: Tags: Images in Thorax, Journalology, Lung neoplasms, Drugs: infectious diseases, TB and other respiratory infections, Lung cancer (oncology), Screening (oncology), Inflammation, Lung cancer (respiratory medicine), Cardiothoracic surgery, Ethics Chest clinic Source Type: research