Long-term survival after multidisciplinary treatment for large-size secondary osteosarcoma of the rib: A case report

JOS Case Reports Pub Date : 2023-07-01 DOI:10.1016/j.joscr.2023.02.002

Kei Takeuchi , Naofumi Asano , Kyohei Masai , Kayo Yoshida , Satoshi Kamio , Sayaka Yamaguchi , Tomoaki Mori , Robert Nakayama , Hajime Ohkita , Hisao Asamura , Morio Matsumoto , Masaya Nakamura

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Abstract

Background

Secondary high-grade rib osteosarcoma is a very rare condition.

Case presentation

A 27-year-old woman presented with a bulging rib discovered on chest radiography, and fibrous dysplasia is suspected. A 15-cm chest wall tumor with osteolytic and sclerosing changes was observed 10 years later. Histologically, osteosarcoma was diagnosed, and no distant metastasis was found. Chemotherapy was performed, but the tumor grew over time, eventually filling the entire left thoracic cavity. Consequently, the patient had a pneumonectomy with wide chest wall resection. Despite allowing for an en bloc resection, the surgical margin was positive, necessitating postoperative radiotherapy. There has been no recurrence 5 years after surgery.

Conclusions

This is most likely a secondary osteosarcoma arising from rib fibrous dysplasia. It is suggested that imaging follow-up is important for early detection of malignant transformation.

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肋骨大面积继发性骨肉瘤多学科治疗后的长期生存1例

背景继发性高级别肋骨骨肉瘤是一种非常罕见的疾病。病例介绍：一位27岁的女性在胸部X光检查中发现肋骨隆起，怀疑纤维发育不良。10年后观察到一个15厘米的胸壁肿瘤，伴有溶骨性和硬化性变化。组织学诊断为骨肉瘤，未发现远处转移。进行了化疗，但肿瘤随着时间的推移而生长，最终填充了整个左胸腔。因此，患者进行了全肺切除术和宽胸壁切除术。尽管允许整体切除，但手术切缘是阳性的，需要术后放疗。手术后5年没有复发。结论这很可能是肋骨纤维发育不良引起的继发性骨肉瘤。提示影像学随访对早期发现恶性转化具有重要意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JOS Case Reports

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