10 y/o boy with chest pain, known case of femoral osteosarcoma

 

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Doctor's Information

Name : Hamidreza
Family : Haghighatkhah
Affiliation :Radiology department,ShohadaTajrish Hospital,SBMU
Academic Degree : Associate professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Mehdi Shahryari

 

Case Section

Chest Imaging

 

Patient's Information

Gender : Male
Age : 10

 

Clinical Summary

10 y/o boy with chest pain, known case of femoral osteosarcoma

 

Imaging Findings

X-ray shows multiple dense lesions in the left and right lung. Ct scan shows multiple variable size calcified lung lesions in both lungs that the largest of them is seen in right paracardiac.

 

Differential Diagnosis

Hyperdense pulmonary mass

 

Final Diagnosis

Multiple calcified lung metastases of osteosarocma

 

Discussion (Related Text)

The lungs are one of the most frequent targets of metastatic deposition for many primary tumors. The most common primaries to result in pulmonary metastases include : breast carcinoma, colorectal carcinoma, renal cell carcinoma, uterine leiomyosarcoma, head and neck squamous cell carcinoma. Alternatively, primaries which most frequently metastasise to lungs (although in themselves much less common tumors) include : choriocarcinoma, Ewing sarcoma, malignant melanoma, osteosarcoma, testicular tumors, thyroid carcinoma. Pulmonary metastases typically appear as peripheral, soft tissue attenuation, rounded nodules of variable size, scattered throughout both lungs. . Atypical features include consolidation, cavitation, calcification, hemorrhage and secondary pneumothorax. Calcification, although uncommon and more frequently a feature of benign etiology (e.g. granuloma or hamartoma) is also seen with metastases, particularly those from papillary thyroid carcinoma and adenocarcinomas. Treated metastases, osteosarcomas and chondrosarcomas may also contain calcific densities. Tumours with prominent necrosis located near a pleural surface may result in a pneumothorax. Osteosarcoma is classically described as the pulmonary metastasis that results in pneumothorax. , The most common sarcomas causing secondary spontaneous pneumothorax are osteosarocma and synovial sarcoma.

 

References

1.Pediatric and Adolescent Osteosarcoma By Norman Jaffe, Øyvind S. Bruland.
2.Shields TW. General Thoracic Surgery. (2009) ISBN:0781779820. Read it at Google Books - Find it at Amazon.

 

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