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Gastric wall implantation metastasis of retroperitoneal extraskeletal osteosarcoma: A case report and review of the literature.

Liu Y, Hu B, Li JX, Xing LQ, Liu BP - Oncol Lett (2014)

Bottom Line: The present study analyses a case of retroperitoneal ESOS and its clinical, radiological and therapeutic conditions, and also provides a review of the literature.A 52-year-old male was diagnosed with retroperitoneal ESOS.In the present case, a peritoneal metastatic lesion of ESOS was shed from the peritoneum and implanted into the outer membrane of the stomach and metastasis was identified, this has rarely been reported in the literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China ; Department of Nuclear Medicine, The First Affiliated Hospital of HenNan University of Science and Technology, Luoyang, Henan 471003, P.R. China.

ABSTRACT
Retroperitoneal extraskeletal osteosarcoma (ESOS) is a rare and highly invasive tumor that is usually diagnosed at an advanced stage due to the insidious onset. The present study analyses a case of retroperitoneal ESOS and its clinical, radiological and therapeutic conditions, and also provides a review of the literature. A 52-year-old male was diagnosed with retroperitoneal ESOS. The patient succumbed to the condition one year after the initial surgery. During treatment, the patient underwent two additional surgeries and two courses of chemotherapy. In the present case, a peritoneal metastatic lesion of ESOS was shed from the peritoneum and implanted into the outer membrane of the stomach and metastasis was identified, this has rarely been reported in the literature. Retroperitoneal ESOS should be considered in the differential diagnosis of a retroperitoneal mass in order to facilitate the management of surgery and help determine the appropriate treatment of the disease.

No MeSH data available.


Related in: MedlinePlus

Representative abdominal computed tomography (CT) findings (A) prior to and (B and C) following the first surgery. (A) Prior to the first surgery, abdominal CT showed a large dense mass with calcification (arrowhead) located below the right kidney. (B) Two months after the first surgery, CT demonstrated a mass (arrowhead), with a large calcified lesion, anterior to the right psoas muscle. The renal fascia and abdominal wall showed multiple calcified foci (arrow). (C) Nine months after the first surgery, CT revealed calcified lesions (arrow) in the outer stomach anterior wall and hepatic surface.
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f1-ol-08-06-2431: Representative abdominal computed tomography (CT) findings (A) prior to and (B and C) following the first surgery. (A) Prior to the first surgery, abdominal CT showed a large dense mass with calcification (arrowhead) located below the right kidney. (B) Two months after the first surgery, CT demonstrated a mass (arrowhead), with a large calcified lesion, anterior to the right psoas muscle. The renal fascia and abdominal wall showed multiple calcified foci (arrow). (C) Nine months after the first surgery, CT revealed calcified lesions (arrow) in the outer stomach anterior wall and hepatic surface.

Mentions: A 52-year-old male was hospitalized with intermittent pain in the right abdomen that had persisted for one week. The medical history revealed hypertension, but no history of trauma and radiation exposure or a family history of genetic diseases. Physical examination showed a large, hard, immobile mass with a smooth surface, ~6×6 cm in size. Laboratory tests revealed a small increase in the serum creatinine level to 120 μmol/l (normal range, 40–110 μmol/l), while the remaining results, including that for alkaline phosphatase (ALP), were normal. An abdominal computed tomography (CT) scan (Fig. 1) showed a large, dense mass, with calcification, located below the right kidney, an oppressed upper ureter and thickening of the renal fascia. An exploratory laparotomy discovered a stiff calcified immobile retroperitoneal mass of 5×6 cm, with a wide base below the right kidney. The mass could not be completely resected of its attachment to the surrounding organs. Pathology revealed that the tumor was composed of spindle- and polygonal-shaped tumor cells, with a banded or irregular osteoid matrix. The tumor cells exhibited varying degrees of atypia and visible mitotic figures (Fig. 2). From these results, a diagnosis of extraskeletal osteosarcoma was formed. Immunohistochemistry showed the positive expression of vimentin and S-100, whereas examination of cytokeratin, cluster of differentiation (CD)117, CD34, epithelial membrane antigen, melanoma, B-cell lymphoma-2 and CD99 staining was negative.


Gastric wall implantation metastasis of retroperitoneal extraskeletal osteosarcoma: A case report and review of the literature.

Liu Y, Hu B, Li JX, Xing LQ, Liu BP - Oncol Lett (2014)

Representative abdominal computed tomography (CT) findings (A) prior to and (B and C) following the first surgery. (A) Prior to the first surgery, abdominal CT showed a large dense mass with calcification (arrowhead) located below the right kidney. (B) Two months after the first surgery, CT demonstrated a mass (arrowhead), with a large calcified lesion, anterior to the right psoas muscle. The renal fascia and abdominal wall showed multiple calcified foci (arrow). (C) Nine months after the first surgery, CT revealed calcified lesions (arrow) in the outer stomach anterior wall and hepatic surface.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4214496&req=5

f1-ol-08-06-2431: Representative abdominal computed tomography (CT) findings (A) prior to and (B and C) following the first surgery. (A) Prior to the first surgery, abdominal CT showed a large dense mass with calcification (arrowhead) located below the right kidney. (B) Two months after the first surgery, CT demonstrated a mass (arrowhead), with a large calcified lesion, anterior to the right psoas muscle. The renal fascia and abdominal wall showed multiple calcified foci (arrow). (C) Nine months after the first surgery, CT revealed calcified lesions (arrow) in the outer stomach anterior wall and hepatic surface.
Mentions: A 52-year-old male was hospitalized with intermittent pain in the right abdomen that had persisted for one week. The medical history revealed hypertension, but no history of trauma and radiation exposure or a family history of genetic diseases. Physical examination showed a large, hard, immobile mass with a smooth surface, ~6×6 cm in size. Laboratory tests revealed a small increase in the serum creatinine level to 120 μmol/l (normal range, 40–110 μmol/l), while the remaining results, including that for alkaline phosphatase (ALP), were normal. An abdominal computed tomography (CT) scan (Fig. 1) showed a large, dense mass, with calcification, located below the right kidney, an oppressed upper ureter and thickening of the renal fascia. An exploratory laparotomy discovered a stiff calcified immobile retroperitoneal mass of 5×6 cm, with a wide base below the right kidney. The mass could not be completely resected of its attachment to the surrounding organs. Pathology revealed that the tumor was composed of spindle- and polygonal-shaped tumor cells, with a banded or irregular osteoid matrix. The tumor cells exhibited varying degrees of atypia and visible mitotic figures (Fig. 2). From these results, a diagnosis of extraskeletal osteosarcoma was formed. Immunohistochemistry showed the positive expression of vimentin and S-100, whereas examination of cytokeratin, cluster of differentiation (CD)117, CD34, epithelial membrane antigen, melanoma, B-cell lymphoma-2 and CD99 staining was negative.

Bottom Line: The present study analyses a case of retroperitoneal ESOS and its clinical, radiological and therapeutic conditions, and also provides a review of the literature.A 52-year-old male was diagnosed with retroperitoneal ESOS.In the present case, a peritoneal metastatic lesion of ESOS was shed from the peritoneum and implanted into the outer membrane of the stomach and metastasis was identified, this has rarely been reported in the literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Nuclear Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China ; Department of Nuclear Medicine, The First Affiliated Hospital of HenNan University of Science and Technology, Luoyang, Henan 471003, P.R. China.

ABSTRACT
Retroperitoneal extraskeletal osteosarcoma (ESOS) is a rare and highly invasive tumor that is usually diagnosed at an advanced stage due to the insidious onset. The present study analyses a case of retroperitoneal ESOS and its clinical, radiological and therapeutic conditions, and also provides a review of the literature. A 52-year-old male was diagnosed with retroperitoneal ESOS. The patient succumbed to the condition one year after the initial surgery. During treatment, the patient underwent two additional surgeries and two courses of chemotherapy. In the present case, a peritoneal metastatic lesion of ESOS was shed from the peritoneum and implanted into the outer membrane of the stomach and metastasis was identified, this has rarely been reported in the literature. Retroperitoneal ESOS should be considered in the differential diagnosis of a retroperitoneal mass in order to facilitate the management of surgery and help determine the appropriate treatment of the disease.

No MeSH data available.


Related in: MedlinePlus