1988 Volume 28 Issue 7 Pages 877-882
We report a case of metastatic osteosarcoma which showed prominent accumulation of radioisotope on bone scintigraphy and was treated with extended resection. The patient is a 44 year-old male who underwent amputation above the knee for osteogenic sarcoma of the left thigh when he was 38 years old. Four years later, well-circumscribed tumors in the left lung field and the nearby chest wall were detected on the plain chest roentgenogram. There was prominent accumulation of the radioisotope on the bone scintigram over the same area. Left lower lobectomy with partial resection of the adjacent chest wall was carried out. Pathological examination confirmed the resected tumor to be metastatic from the osteogenic sarcoma. Two years later, a huge recurrence in and around the left thoracic cage was recognized. Strong hot spots were also evidenced on the bone scintigram. The metastatic tumor involved the left chest wall, mediastinum, diaphragm, and the retroperitoneum. Tumor was extirpated with completion pneumonectomy, total resection of the parietal pleura, extended resection of the left chest wall (8 ribs were resected), wide resection of the pericardium and subtotal resection of the left hemidiaphragm. Two years after this procedure, the patient is well-rehabilitated.
