title: Metastasis of osteosarcoma to stomach made clinically evident by hematemesis: a case report.
abstract: BACKGROUND
  Gastric metastasis from osteosarcoma is very rare and its clinical features are not well recognized.
  
  
  METHODS
  A 73-year-old man was diagnosed with osteosarcoma and treated with four cycles of preoperative chemotherapy with ifosfamide and doxorubicin followed by wide resection. Two cycles of postoperative chemotherapy with ifosfamide and doxorubicin and ten cycles of chemotherapy with carboplatin and etoposide were administered. Eleven months after the surgery, he vomited fresh blood. Unusual progression of anemia was observed with the hematemesis. A biopsy was performed by gastrointestinal endoscopy, and the stomach tumor was diagnosed as metastasis of osteosarcoma.
  
  
  CONCLUSIONS
  Even though gastric metastasis from osteosarcoma is very rare, all three previous reports and our case showed the presence of ulcer on the surface of the gastric lesion. We should consider the possibility of gastric metastasis in patients with osteosarcoma in whom progression of anemia or gastric hemorrhage is observed.
authors: Department of Orthopedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa-ku, 466-8550, Nagoya, Aichi, Japan. urakawa@med.nagoya-u.ac.jp
authors: Hiroshi
authors: H
authors: Urakawa
authors: Satoshi
authors: S
authors: Tsukushi
authors: Issei
authors: I
authors: Tsurudome
authors: Akihiro
authors: A
authors: Hirata
authors: Eisuke
authors: E
authors: Arai
authors: Eiji
authors: E
authors: Kozawa
authors: Naohisa
authors: N
authors: Futamura
authors: Ryoji
authors: R
authors: Miyahara
authors: Naoki
authors: N
authors: Ishiguro
authors: Yoshihiro
authors: Y
authors: Nishida
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000473:pathology / Q000628:therapy*; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005743:Gastrectomy; D006396:Hematemesis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008297:Male; D009367:Neoplasm Staging; D012516:Osteosarcoma / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000556:secondary* / Q000601:surgery
chemical_list: D005047:Etoposide; D004317:Doxorubicin; D016190:Carboplatin; D002945:Cisplatin; D007069:Ifosfamide