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Journal of Cancer Research and Therapeutics, Vol. 7, No. 2, April-June, 2011, pp. 229-230 Letter to the Editor Solitary anterior abdominal wall metastasis from osteogenic sarcoma of fibula as detected by FDG-PET imaging Sandip Basu1, Sangeeta B Desai2 1 Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, Maharashtra, India PMID: 21768725 DOI: 10.4103/0973-1482.82935 Sir, An unusual case of osteosarcoma with metastasis to the subcutaneous lump in the abdominal wall is presented. The patient, a 21-year-old female, who was diagnosed to have osteogenic sarcoma of the left fibula, had undergone left fibulectomy 3 years previously. She presented with a recent onset feeling of circumscribed hardening of the anterior abdominal wall. FDG-PET study was undertaken for whole body disease survey, which demonstrated two foci of abnormal uptake, one of which corresponded to the area of hardening and the uptake was through the skin and subcutaneous tissue [Figure - 1]a and b. Another tiny focus of abnormal FDG uptake was noted just posterior and superior to the urinary bladder [Figure - 1]a and b, which persisted in the delayed imaging. A tissue diagnosis was sought for in view of a very unusual site of disease recurrence for osteosarcoma, which proved the fair-sized lesion in the anterior abdominal wall noted in the FDG-PET to be a metastasis from osteosarcoma [Figure - 2]a and b. The case upholds the fact that recurrences at unusual sites can occur after an apparent prolonged disease-free survival and underscores the importance of regular and long-term follow-up with whole body FDG-PET in this setting. Functional imaging plays pivotal role in monitoring disease activity [1] and can aid in detecting and monitoring unusual sites of metastases in osteosarcoma [2],[3] or unusual primary osteosarcomas of the soft tissue organ. [4] The whole body evaluation is a distinct advantage of FDG-PET in this regard. We have previously reported isolated breast metastasis and adrenal metastasis in the setting of osteosarcoma [2],[3] where such functional imaging played a critical role in detecting the metastatic disease at unusual sites. The present case is a useful addition to these reports. References
Copyright 2011 - Journal of Cancer Research and Therapeutics The following images related to this document are available:Photo images[cr11059f2.jpg] [cr11059f1.jpg] |
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