title: Lung metastasis 21 years after initial diagnosis of osteosarcoma: a case report.
abstract: BACKGROUND
  To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma.
  
  
  METHODS
  A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later.
  
  
  CONCLUSIONS
  This case highlights the importance of long follow-up periods and continued surveillance of osteosarcoma patients after initial curative treatment.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Texas Tech University, Lubbock, TX, USA.
authors.forename: Ari
authors.initials: A
authors.lastname: Halldorsson
authors.forename: Steven
authors.initials: S
authors.lastname: Brooks
authors.forename: Sam
authors.initials: S
authors.lastname: Montgomery
authors.forename: Suzanne
authors.initials: S
authors.lastname: Graham