title: Simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma.
abstract: Thromboembolism presenting with malignancy is common in adults but rare in children. We describe the case of a 17-year-old boy admitted to our hospital with syncope. Computed tomography revealed thromboembolism in both the lungs. Magnetic resonance imaging found thromboembolism in the inferior vena cava and a large heterogeneous mass in the pelvis. Pelvic osteosarcoma was confirmed by computed tomography-guided biopsy. Despite intensive chemotherapy and local radiation, only transient response was noted, the tumor remaining unresectable. To our knowledge, this is the first reported case of simultaneous pulmonary and inferior vena cava thromboembolism secondary to pelvic osteosarcoma in children. We also emphasize syncope as a unique feature of pulmonary thromboembolism. Accordingly, thromboembolism should be kept in mind as the first manifestation of occult malignancy, even in children.
authors.affiliation: *Departments of Radiology #Pediatrics **Pathology †School of Medicine ‡‡School of Chinese Medicine, China Medical University ‡Departments of Medical Imaging and Radiological Science §Children Education and Enterprise, Central Taiwan University of Science and Technology ∥Department of Pediatrics ¶School of Medicine, Chung Shan Medical University ††Department of Pediatrics, Buddhist Tzu-Chi General Hospital, Taichung Branch, Taichung, Taiwan.
authors.forename: Wei-Ching
authors.initials: WC
authors.lastname: Lin
authors.forename: Chien-Heng
authors.initials: CH
authors.lastname: Lin
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Chao
authors.forename: Hsiao-Chuan
authors.initials: HC
authors.lastname: Lin
authors.forename: Pei-Yu
authors.initials: PY
authors.lastname: Chen
authors.forename: Han-Ping
authors.initials: HP
authors.lastname: Wu
authors.forename: Kang-Hsi
authors.initials: KH
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000150:complications* / Q000473:pathology; D006801:Humans; D008297:Male; D012516:Osteosarcoma / Q000150:complications* / Q000473:pathology; D010386:Pelvic Neoplasms / Q000150:complications* / Q000473:pathology; D011655:Pulmonary Embolism / Q000209:etiology*; D013575:Syncope / Q000209:etiology; D014682:Vena Cava, Inferior / Q000473:pathology*; D054556:Venous Thromboembolism / Q000209:etiology