Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature

Introduction. We present the extremely rare case of a patient with three metachronous osteosarcomas within 22 years without evident pulmonary manifestation of disease 30 years after first diagnosis. Case Presentation. In 1983, a high-grade osteosarcoma of the left distal femur was diagnosed in an 18...

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Main Authors: Ulrike Michaela Pirker-Frühauf, Jörg Friesenbichler, Katharina Rabitsch, Bernadette Liegl-Atzwanger, Thomas Bauernhofer, Reinhard Windhager, Andreas Leithner
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2013/197287
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author Ulrike Michaela Pirker-Frühauf
Jörg Friesenbichler
Katharina Rabitsch
Bernadette Liegl-Atzwanger
Thomas Bauernhofer
Reinhard Windhager
Andreas Leithner
author_facet Ulrike Michaela Pirker-Frühauf
Jörg Friesenbichler
Katharina Rabitsch
Bernadette Liegl-Atzwanger
Thomas Bauernhofer
Reinhard Windhager
Andreas Leithner
author_sort Ulrike Michaela Pirker-Frühauf
collection DOAJ
description Introduction. We present the extremely rare case of a patient with three metachronous osteosarcomas within 22 years without evident pulmonary manifestation of disease 30 years after first diagnosis. Case Presentation. In 1983, a high-grade osteosarcoma of the left distal femur was diagnosed in an 18-year-old Caucasian male. He received rotationplasty accompanied by pre- and postoperative chemotherapy. Ten years later, an osteoblastic osteosarcoma occurred in TH12. En bloc resection and pre- and postoperative chemotherapy followed. In 2005, the patient developed another high-grade osteosarcoma in his right distal femur. Treatment included a wide resection and reconstruction with a tumour endoprosthesis as well as (neo)adjuvant chemotherapy. After the third tumour occurrence, cytogenetic and molecular genetic examinations (p53, rb1) were performed, showing a normal genetic pattern. Screening for metastases never showed clinical evidence of extraskeletal tumour manifestation. Discussion. In patients presenting metachronous osteosarcoma, identification of their lesions clonality (second primary tumour or metastases) could lead to a better understanding of tumour development and help to filter patients who need extended long-term followup due to a higher risk of late occurring sarcoma recurrence.
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institution OA Journals
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series Case Reports in Orthopedics
spelling doaj-art-29889ed8348e4a698b588a1da49815a82025-08-20T02:03:59ZengWileyCase Reports in Orthopedics2090-67492090-67572013-01-01201310.1155/2013/197287197287Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the LiteratureUlrike Michaela Pirker-Frühauf0Jörg Friesenbichler1Katharina Rabitsch2Bernadette Liegl-Atzwanger3Thomas Bauernhofer4Reinhard Windhager5Andreas Leithner6Department of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, 8036 Graz, AustriaDepartment of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, 8036 Graz, AustriaDepartment of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, 8036 Graz, AustriaDepartment of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036 Graz, AustriaDivision of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Orthopaedic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Wien, AustriaDepartment of Orthopaedic Surgery, Medical University of Graz, Auenbruggerplatz 5-7, 8036 Graz, AustriaIntroduction. We present the extremely rare case of a patient with three metachronous osteosarcomas within 22 years without evident pulmonary manifestation of disease 30 years after first diagnosis. Case Presentation. In 1983, a high-grade osteosarcoma of the left distal femur was diagnosed in an 18-year-old Caucasian male. He received rotationplasty accompanied by pre- and postoperative chemotherapy. Ten years later, an osteoblastic osteosarcoma occurred in TH12. En bloc resection and pre- and postoperative chemotherapy followed. In 2005, the patient developed another high-grade osteosarcoma in his right distal femur. Treatment included a wide resection and reconstruction with a tumour endoprosthesis as well as (neo)adjuvant chemotherapy. After the third tumour occurrence, cytogenetic and molecular genetic examinations (p53, rb1) were performed, showing a normal genetic pattern. Screening for metastases never showed clinical evidence of extraskeletal tumour manifestation. Discussion. In patients presenting metachronous osteosarcoma, identification of their lesions clonality (second primary tumour or metastases) could lead to a better understanding of tumour development and help to filter patients who need extended long-term followup due to a higher risk of late occurring sarcoma recurrence.http://dx.doi.org/10.1155/2013/197287
spellingShingle Ulrike Michaela Pirker-Frühauf
Jörg Friesenbichler
Katharina Rabitsch
Bernadette Liegl-Atzwanger
Thomas Bauernhofer
Reinhard Windhager
Andreas Leithner
Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
Case Reports in Orthopedics
title Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
title_full Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
title_fullStr Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
title_full_unstemmed Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
title_short Three Metachronous Osteosarcomas within 22 Years without Pulmonary Metastases: A Case Report and Review of the Literature
title_sort three metachronous osteosarcomas within 22 years without pulmonary metastases a case report and review of the literature
url http://dx.doi.org/10.1155/2013/197287
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