Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature. (25th December 2013)

• Record Type: Journal Article
• Authors: Pirker-Frühauf, Ulrike Michaela; Friesenbichler, Jörg; Rabitsch, Katharina; Liegl-Atzwanger, Bernadette; Bauernhofer, Thomas; Windhager, Reinhard; Leithner, Andreas
• Other Names: Erler K. Academic Editor.; Faisham W. I. Academic Editor.; Sakamoto A. Academic Editor.; Yasuda T. Academic Editor.
• Is Part Of: Case reports in orthopedics. Volume 2013(2013)
• Publication Date: 2013-12-25
• Subjects: Orthopedics -- Periodicals; Orthopedics; Orthopedics; Periodicals; Electronic journals; Periodicals; 616.7
• DOI: 10.1155/2013/197287
• Languages: English
• ISSNs: 2090-6749

Abstract

Abstract : Introduction . We present the extremely rare case of a patient with three metachronous osteosarcomas within 22 years without evident pulmonary manifestation of disease 30 years after first diagnosis. Case Presentation . In 1983, a high-grade osteosarcoma of the left distal femur was diagnosed in an 18-year-old Caucasian male. He received rotationplasty accompanied by pre- and postoperative chemotherapy. Ten years later, an osteoblastic osteosarcoma occurred in TH12. En bloc resection and pre- and postoperative chemotherapy followed. In 2005, the patient developed another high-grade osteosarcoma in his right distal femur. Treatment included a wide resection and reconstruction with a tumour endoprosthesis as well as (neo)adjuvant chemotherapy. After the third tumour occurrence, cytogenetic and molecular genetic examinations (p53, rb1) were performed, showing a normal genetic pattern. Screening for metastases never showed clinical evidence of extraskeletal tumour manifestation. Discussion . In patients presenting metachronous osteosarcoma, identification of their lesions clonality (second primary tumour or metastases) could lead to a better understanding of tumour development and help to filter patients who need extended long-term followup due to a higher risk of late occurring sarcoma recurrence.