title: Abdominal recurrence of osteogenic sarcoma: a case report.
abstract: OBJECTIVE
  Nonpulmonary metastases from osteogenic sarcoma are rare. A patient had a localized osteogenic sarcoma of the left femur which recurred in the abdomen, a previously unreported metastatic site.
  
  
  METHODS
  An 18-year-old boy was treated for osteosarcoma. He had abdominal pain, vomiting, weight loss, and symptoms of intestinal obstruction at the time of relapse.
  
  
  RESULTS
  The patient had diffuse widespread intraabdominal osteogenic sarcoma as the only site of initial recurrence. Abdominal computerized tomography revealed ascites and calcified masses on the hepatic and peritoneal surfaces. Laparoscopic visualization of the abdomen showed hemorrhagic ascites and multiple calcified tumor on the peritoneum, diaphragm, and liver. A biopsy of a representative lesion confirmed the diagnosis of osteogenic sarcoma. The patient died from progressive disease.
  
  
  CONCLUSIONS
  As the initial treatment for patients with osteogenic sarcoma is intensified, the pattern of metastases may change. Unusual sites of recurrence such as in this patient may become more prevalent. A clinical presentation of an acute abdomen in a patient previously treated for osteogenic sarcoma should prompt suspicion of intraabdominal recurrence.
authors.affiliation: Department of Pediatric Oncology, Hospital do Cancer A. C. Camargo, Sao Paulo, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Costa
authors.forename: B
authors.initials: B
authors.lastname: de Camargo
authors.forename: R
authors.initials: R
authors.lastname: Bagietto
authors.forename: P S
authors.initials: PS
authors.lastname: Alcantra
authors.forename: R
authors.initials: R
authors.lastname: Chojniak
authors.forename: S T
authors.initials: ST
authors.lastname: Sredni
mesh_terms: D000008:Abdominal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D000293:Adolescent; D017809:Fatal Outcome; D005266:Femoral Neoplasms / Q000473:pathology; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed