METASTATIC OSTEOSARCOMA TO THE LIVER AFTER TREATMENT FOR SYNOVIAL SARCOMA: A Case Report

Abstract

Metastatic osteosarcoma most commonly affects the lungs and other bones. Hepatic metastasis at the time of diagnosis is extremely rare. A 14-year-old boy with synovial sarcoma of the left popliteal fossa was treated with surgical resection, radiotherapy for microscopic residual disease, and 1 year of chemotherapy (vincristine, cyclophosphamide, dactinomycin, and doxorubicin). Approximately 10 years after the initial diagnosis, a secondary osteosarcoma developed in the left proximal tibia. Computed tomography at presentation showed bilateral pulmonary metastases and large ossified nodules in the liver that demonstrated abnormal avidity on 99mTc MDP bone scan indicating hepatic metastasis. Despite chemotherapy (cisplatin, ifosfamide, high-dose methotrexate, and dacarbazine), the patient died of progressive disease 4 months after the diagnosis of the second cancer. Hepatic metastasis was found at the time of diagnosis of a secondary osteosarcoma and manifested as ossified nodules. The risk of radiation-induced osteosarcoma should always be considered in decisions about treatment for soft-tissue sarcoma.

Metastatic osteosarcoma to the liver and the kidney: a case report and review of the literature

“…O’Mara et al ,4 Shapiro et al 5 and Daw et al 6 report cases of osteosarcoma with metastatic lesion to the liver with or without simultaneous pulmonary metastases. Dalinka et al 7 describe a case of extraskeletal osteosarcoma (a primary osteosarcoma in the kidney) with metastasis to the liver.…”

Shilajit potentiates the effect of chemotherapeutic drugs and mitigates metastasis induced liver and kidney damages in osteosarcoma rats

“…These variations are reported to be caused due to differences in the expression of relevant genes, changes in molecule profiles as well as interaction with tumor surroundings ( Gorlick et al, 2003 , PosthumaDeBoer et al, 2011 ). Several recent and previous studies reported that osteosarcoma could metastasize to extraskeletal organs such as the liver and kidney, rendering the disease treatment more complex and difficult ( Dalinka et al, 1971 , Daw et al, 2001 , Hagay et al, 1986 , Sigdel et al, 2021 ). Chemotherapy remained the primary choice for the treatment of metastasized OS.…”

Pigment Epithelium Derived Factor Is Involved in the Late Phase of Osteosarcoma Metastasis by Increasing Extravasation and Cell-Cell Adhesion

“…High-grade osteosarcomas have a high propensity for pulmonary metastasis; over 75% of metastatic OS cases involve the lung. Other organ metastases are extremely rare; however, the renal metastasis of OS is often found with pulmonary metastasis after death (3), and the hepatic metastasis of OS is found microscopically after chemotherapy (4). Usually the OS metastasize hematogeneously to lung and bones but rarely to lymph nodes (5).…”