Intracranial Manifestation of Osteosarcoma

Abstract

Involvement of the central nervous system in osteosarcoma is uncommon. These neoplasms are most often located at the metaphyses of tubular bones and rarely in flat bones of vertebra, ribs, pelvis, facial bones, or skull. Tumors of the latter bones may obviously spread into the cerebrum. Osteosarcomas primarily metastasize hematogenously to the lungs. Bone, lymph node, or brain metastases are mostly seen following or concomitantly with pulmonary metastatic disease. However, there are single cases of primary osteosarcoma of the brain parenchyma without bone association or tumor manifestation at other locations. Three illustrative cases highlight the diversity of the clinical presentation of cerebral osteosarcoma: a 22-year-old man with multiple brain metastases following late pulmonary relapse of an osteosarcoma of the tibia, a 31-year-old woman with an osteosarcoma of the left anterior cranial fossa arising from the skull base, and a 78-year-old man presenting with primary osteogenic sarcoma of the left frontal cerebral hemisphere. According to the current literature, 10-15% of all osteosarcoma patients experiencing relapse may beat risk for central nervous system metastases. To the authors' best knowledge, there are 11 cases of primary intracerebral or meningeal osteogenic sarcoma, including this case report, without any skeletal attachment.

Central nervous system metastasis from osteosarcoma: Case report and literature review

“…Approximately 30-40% of patients with localized tumors develop lung metastasis and 10-15% of those patients experienced relapse, they may be at risk of brain metastasis [18], we found 75.86% of patients with lung metastases.…”

“…It has been described that brain lesions caused by osteosarcoma are hypervascularized and mimic multiform glioblastoma [11]. Generally, they are located in the cerebral cortex, although some cases in the cerebellum have also been reported [18,24]. In the patient described in this case, metastases were found in the right frontoparietal region of the cerebral cortex.…”

Brain Metastases in a 12-Year-Old Girl with Osteosarcoma: A Case Report

“…Ten to 15% of patients with pulmonary involvement have simultaneous central nervous system metastasis (10).…”

Calcified Brain Metastases from Osteosarcoma

“…Therefore calcification of brain metastases has been proposed as an indicator of slow progression and longer survival 3 , although results in the literature remain controversial 4 . Pulmonary adenocarcinoma has been consistently reported as the most common primary tumor 4 though calcification seems to be especially associated with metastases from osteogenic osteosarcoma 5 . In the case described here, the presence of associated mass effect and surrounding edema on neuroimaging is in keeping with a metastatic origin of the lesions; the confirmed osteogenic osteosarcoma the likely primary tumor.…”