title: Pulmonary Relapse of Osteosarcoma Following Presentation With a Pneumomediastinum and Localized Disease at Diagnosis.
abstract: Pneumothorax is a well-described complication of osteosarcoma. Conversely, the presence of a pneumomediastinum to our knowledge has been reported just once in a patient with osteosarcoma, and never without detectable lung metastasis. We report the case of an 18-year-old male with a localized, distal femur osteosarcoma who was found to have an asymptomatic pneumomediastinum and pneumatocele at diagnosis, and then 16 months later experienced a pulmonary relapse. Our case suggests that these findings may represent the presence of occult metastatic disease and cautions providers to treat appropriately and provide surveillance with a high index of suspicion for pulmonary recurrence.
authors.affiliation: *Emory University School of Medicine Departments of †Radiology and Imaging Sciences ‡Pediatrics, Emory University, Children's Healthcare of Atlanta §Children's Healthcare of Atlanta, Atlanta, GA ∥Department of Pediatrics, Vanderbilt University, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN.
authors.forename: Sarayu
authors.initials: S
authors.lastname: Kumar
authors.forename: Adina
authors.initials: A
authors.lastname: Alazraki
authors.forename: Bradley
authors.initials: B
authors.lastname: George
authors.forename: Melissa
authors.initials: M
authors.lastname: Martin
authors.forename: Howard M
authors.initials: HM
authors.lastname: Katzenstein
authors.forename: Thomas
authors.initials: T
authors.lastname: Cash
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000556:secondary* / Q000628:therapy; D008297:Male; D008482:Mediastinum / Q000473:pathology*; D012516:Osteosarcoma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed