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Multifocal osteosarcoma: an unusual presentation
S Gunawardena1, M Chintagumpala, L Trautwein
1Texas Children's Cancer Center, Houston 77030-2399, USA.
Purpose:
Report the unusual presentation, clinical course, and cytogenetic abnormalities in a child with multifocal osteosarcoma.
Patients And Methods:
A 10-year-old boy had multifocal osteosarcoma involving the entire skeleton, pleura, bone marrow, and lungs. He had marked anemia, thrombocytopenia, and severe hypocalcemia at diagnosis.
Results:
Despite aggressive chemotherapy, he died from progressive disease 1 month after diagnosis. Cytogenetic analysis of tumor cells within the pleural fluid showed multiple chromosomal abnormalities with amplification of the c-myc oncogene.
Conclusion:
Multifocal osteosarcoma should be considered in the differential diagnosis of a child with pancytopenia and multiple bone lesions. Amplification of the c-myc oncogene may have had a significant role in the pathogenesis, etiology, and rapid progression of this patient's multifocal disease. Additional studies will be needed to determine the biologic significance of c-myc amplification in multifocal osteosarcoma.