Metastatic osteosarcoma presenting as a single pulmonary microembolus

J Pediatr Surg. 2011 Mar;46(3):574-6. doi: 10.1016/j.jpedsurg.2011.01.001.

Abstract

There are only a few published reports of tumor emboli from osteosarcoma. We are reporting a 17-year-old adolescent boy with a history of localized osteosarcoma who developed a symptomatic pulmonary artery tumor embolus. He was initially diagnosed with a pulmonary thromboembolism. This is the first reported case of a single tumor embolus developing after surgical resection of a tumor with 100% necrosis after chemotherapy and no evidence of metastatic disease at the time of surgery. Pulmonary tumor embolism should be considered in the differential diagnosis in patients with cancer who present with dyspnea. The differentiation of tumor embolus from other causes of dyspnea is important for treatment plan.

MeSH terms

  • Adolescent
  • Anticoagulants / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Diagnostic Errors
  • Enoxaparin / therapeutic use
  • Etoposide / administration & dosage
  • Femoral Neoplasms / drug therapy
  • Femoral Neoplasms / surgery*
  • Humans
  • Ifosfamide / administration & dosage
  • Limb Salvage
  • Male
  • Neoplastic Cells, Circulating*
  • Osteosarcoma / diagnosis
  • Osteosarcoma / diagnostic imaging
  • Osteosarcoma / drug therapy
  • Osteosarcoma / secondary*
  • Osteosarcoma / surgery
  • Pneumonectomy / methods
  • Postoperative Complications / diagnosis*
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / surgery
  • Thromboembolism / diagnosis
  • Tomography, X-Ray Computed

Substances

  • Anticoagulants
  • Enoxaparin
  • Etoposide
  • Ifosfamide