title: Osteosarcoma metastatic to the kidney and iatrogenic hemorrhage.
abstract: A 16-year old female presented painful masses in the lumbar region 5 years after the initial diagnosis of a localized osteosarcoma of the tibia. Abdominal X-ray revealed calcified masses. A bone scan confirmed an increased uptake in the renal areas. An ultrasound-guided fine needle biopsy confirmed the diagnosis of metastases. The procedure was complicated by subcapsular hemorrhage and gross hematuria. Renal metastases from osteosarcoma are usually asymptomatic and invisible on abdominal X-rays. The diagnosis is generally established by radionuclide bone scan or abdominal CT-scan. Our observation suggests that histological documentation of these unusual clinical presentations should be carefully weighed against the risk of the procedure.
authors.affiliation: Department of Pediatrics, Centre Léon Bérard, Lyon Cedex, France. marec@lyon.fnclcc.fr
authors.forename: Perrine
authors.initials: P
authors.lastname: Marec-Bérard
authors.forename: Nicolas
authors.initials: N
authors.lastname: Crassard
authors.forename: Matthias
authors.initials: M
authors.lastname: Schell
authors.forename: Thierry
authors.initials: T
authors.lastname: Philip
authors.forename: Philippe
authors.initials: P
authors.lastname: Thiesse
authors.forename: Bruno
authors.initials: B
authors.lastname: Ranchin
authors.forename: Didier
authors.initials: D
authors.lastname: Frappaz
mesh_terms: D000671:Amputation, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000601:surgery*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology; D002166:Camptothecin / Q000031:analogs & derivatives / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D017809:Fatal Outcome; D005260:Female; D006417:Hematuria / Q000209:etiology; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D007049:Iatrogenic Disease; D007085:Ilium / Q000473:pathology; D000077146:Irinotecan; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary*; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary / Q000601:surgery; D008727:Methotrexate / Q000008:administration & dosage; D012516:Osteosarcoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D011859:Radiography; D013977:Tibia / Q000473:pathology / Q000601:surgery; D018084:Ultrasonography, Interventional
chemical_list: D000077146:Irinotecan; D004317:Doxorubicin; D002166:Camptothecin; D008727:Methotrexate