title: Diffuse calcification of metastases after intensive multiagent chemotherapy in widespread osteosarcoma leading to death in a 18-year-old male: report of a case and literature review.
abstract: Multifocal osteosarcoma represents a rare and aggressive type of osteosarcoma in which multiple bone lesions are detected simultaneously in the absence of pulmonary or any other visceral organ involvement. Despite a multidisciplinary approach, overall survival remains poor and disease progresses, leading to death within 1 yr of diagnosis. Here we report a case of an 18-yr-old patient with extensively metastatic osteosarcoma developing diffuse calcification in lung, pleural, diaphragm, pericardial, subcutaneous metastases, and mediastinal lymph nodes after intensive multiagent chemotherapy. We provide an extensive review of the literature together with presentation of different aspects regarding the debate on the multicentric versus metastatic hypotheses for multifocal osteosarcoma. An update on the current understanding of the molecular features of this disease is also included.
authors.affiliation: Department of Medicine, 2nd Division of Medical Oncology, Metaxa Cancer Hospital, Pireaus, Greece.
authors.forename: Argyris
authors.initials: A
authors.lastname: Gassiamis
authors.forename: George
authors.initials: G
authors.lastname: Tsakonas
authors.forename: Georgia
authors.initials: G
authors.lastname: Soukouli
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mylonakis
authors.forename: Athanasios
authors.initials: A
authors.lastname: Karabelis
authors.forename: Christos
authors.initials: C
authors.lastname: Kosmas
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001859:Bone Neoplasms / Q000145:classification / Q000188:drug therapy* / Q000473:pathology*; D002114:Calcinosis; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000145:classification / Q000473:pathology; D012516:Osteosarcoma / Q000145:classification / Q000188:drug therapy* / Q000556:secondary*; D014057:Tomography, X-Ray Computed