Multifocal osteosarcoma: an unusual presentation.
OBJECTIVE
Report the unusual presentation, clinical course, and cytogenetic abnormalities in a child with multifocal osteosarcoma.


METHODS
A 10-year-old boy had multifocal osteosarcoma involving the entire skeleton, pleura, bone marrow, and lungs. He had marked anemia, thrombocytopenia, and severe hypocalcemia at diagnosis.


RESULTS
Despite aggressive chemotherapy, he died from progressive disease 1 month after diagnosis. Cytogenetic analysis of tumor cells within the pleural fluid showed multiple chromosomal abnormalities with amplification of the c-myc oncogene.


CONCLUSIONS
Multifocal osteosarcoma should be considered in the differential diagnosis of a child with pancytopenia and multiple bone lesions. Amplification of the c-myc oncogene may have had a significant role in the pathogenesis, etiology, and rapid progression of this patient's multifocal disease. Additional studies will be needed to determine the biologic significance of c-myc amplification in multifocal osteosarcoma.
Gunawardena
S
S
Texas Children's Cancer Center, Houston 77030-2399, USA.
Chintagumpala
M
M
Trautwein
L
L
Brewer
E
E
Gresik
M V
MV
Hicks
M J
MJ
Harrison
W R
WR
Morad
A
A
Cooley
L D
LD
D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D017809:Fatal Outcome; D016259:Genes, myc / Q000235:genetics; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology