spontaneous regression of lung metastasis from osteosarcoma: a case report

Abstract

A case of spontaneous regression of a pulmonary metastasis from high-grade osteosarcoma is reported. The metastasis developed 5 years after chemotherapy and amputation for a distal femur osteosarcoma. The sarcomatous nature of the lesion was histologically confirmed. No treatment was attempted owing to the patient's refusal. The patient was followed up every 3 months and a spontaneous regression of the lesion was documented. Seven years after the diagnosis of lung metastases, no pulmonary nodules or other signs of relapse are present.

Case Details

Disease Location

Pulmonary metastasis from a high-grade osteosarcoma

Personal Characteristics

19 year old male 4-week history of pain and 2 weeks of swelling in right thigh

Clinical Characteristics

Full blood count, erythrocyte sedimentation rate, lactate dehydrogenase, alkaline phosphatase (ap) administered--> displayed high serium levels of ap (980 ui/ml) plain x-rays, CT scan, MRI suggested osteosarcoma trocar biopsy--> grade 4 osteoblastic osteosarcoma

Remission Characteristics

Swelling decreased for about 1/3 and serum levels of ap regressed to normal levels several weeks after beginning preoperative treatment last CT scan was (-) for pulmonary lesions and no secondary bone lesions

Treatment & Mechanisms

Proposed Remission Mechanisms

Unknown, but a mice mnodel of lung metastases demonstrated that expression of particular metastases suppressor genes could interfere with growth of metastatic cells in lung environment

Clinical Treatment

9-week chemotherapy with high-dose methotrexate, adriamycin, cisplatin, ifosfamide thigh amputation adjuvant chemo administered for 14 cycles with above protocol thoracotomy for nodule removal resection of lesion on left arm 3 cycles of high dose ifo