Text in Italics is general (instructional) information
Chest Xray showing multiple metastases
The straight x ray shows a destructive lytic lesion of the proximal tibia at the shaft - diaphyseal junction. There is little soft tissue mineralisation. The MRI shows extensive soft tissue infiltration. Ewings and osteosarcoma must be considered in the differential diagnosis. Not all osteosarcomas show soft tissue mineralisation. The histology confirmed the diagnosis of osteosarcoma.
Multiple pulmonary metastases were present.
Managment Because this patient presented very late, only palliative treatment could be offered. She was treated by chemotherapy followed by AK amputation and pulmonary metastectomy ( about 20 lesions were excised, one had infiltrated the diaphragm). Histology of this tissue showed good tumor response (much tumor necrosis).