title: Osteosarcoma metastasising to the duodenum and pancreas.
abstract: The incidence of metastatic osteosarcoma is increasing because of improved results following multi-agent chemotherapy and resection of the primary tumour. Metastases occur most commonly in the lungs, whereas bowel metastases are rare. We describe a 25-year-old female who presented with melaena six years after successful resection of an osteosarcoma of her right femur, and one year after resection of a solitary pulmonary metastasis. Imaging revealed a lesion arising within both the duodenum and the pancreas for which a Whipple's pancreatoduodenectomy was carried out, achieving complete resection. Histological examination confirmed the diagnosis of metastatic osteosarcoma. We believe this is only the second such case reported. At 11 months post-operatively she had no detectable disease. Although rare, osteosarcoma can metastasise to the intestine. The surgeon must be aware of this complication, and that bowel metastases are potentially resectable.
authors.affiliation: Royal Marsden Hospital, 203, Fulham Road, London SW3, 6JJ, UK.
authors.forename: A
authors.initials: A
authors.lastname: Aarvold
authors.forename: S
authors.initials: S
authors.lastname: Bann
authors.forename: V
authors.initials: V
authors.lastname: Giblin
authors.forename: A
authors.initials: A
authors.lastname: Wotherspoon
authors.forename: S S
authors.initials: SS
authors.lastname: Mudan
mesh_terms: D000328:Adult; D001859:Bone Neoplasms / Q000628:therapy*; D004379:Duodenal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D012516:Osteosarcoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery