Osteosarcoma

Epidemiology

  • Commonly metastasizes to lung (lung is only site of metastasis in 75% of cases)

Physiology

  • Hematogenous dissemination to lungs (occasionally direct extension)
  • Rarely metastasizes elsewhere besides lung and adjacent bone

Diagnosis

CXR/Chest CT Pattern: 3 mm-6 cm (of various size) smooth or slightly lobulated nodules
-Location: lower-lobe predilection
-Calcification: may occur
-Cavitation: sometimes
-Usually absent hilar/mediastinal nodes


Clinical

  • Metastases to Lungs
    • Lung Nodules (see [[Lung Nodule or Mass]])

Complications: Spontaneous occurrence of a second malignancy (supports osteosarcoma resulting from inactive tumor-suppressor gene)


Treatment

Pulmonary metastatectomy: see above
-Combination of prognostic factors: <1 year disease-free interval + >5 mets + doubling time <20 days predicted a post-thoracotomy survival of <12 months in all sarcoma patients
-Some suggest resection of all pulmonary mets in this patient group (due to usual lack of other mets elsewhere)


References

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