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Metastatic Extraskeletal Osteosarcoma

History: 55 year old male with left flank mass on physical exam.  The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural…

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History: 55 year old male with left flank mass on physical exam. 

Coronal contrast enhanced CT scan of the abdomen and pelvis shows a large mass arising from the left lower abdominal wall with cystic and solid components, including foci of calcifications.
Coronal contrast enhanced CT scan of the abdomen and pelvis shows a large mass arising from the left lower abdominal wall with cystic and solid components, including foci of calcifications. A nodule is also seen in the right lung. 
Axial CT scan of the chest without contrast in the same patient one year later after resection of the left flank mass reveals a large mass abutting the right side of the heart. A moderate right and small left pleural effusion are seen.
Axial CT scan of the chest without contrast in the same patient one year later after resection of the left flank mass reveals  the mass in the right lung has markedly enlarged and abuts the right side of the heart. A moderate right and small left pleural effusion are also seen.

The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural effusions in the patient above, which may be malignant effusions. Extraskeletal osteosarcomas may be associated with prior trauma or radiotherapy.

 

2 responses to “Metastatic Extraskeletal Osteosarcoma”

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    […] For an interesting case of extra-skeletal osteosarcoma, click here. […]

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    […] diagnosis from the plain radiograph image above would include entities such as parosteal osteosarcoma (however, not seen in 70 year old patients), myositis ossificans (also referred to as heterotopic […]

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