Case report 669: Osteonecrosis of bone associated with intraarterial therapy using cisplatin

A case is presented of an 18-year-old women who suffered pain and swelling after intraarterial cisplatin chemotherapy for osteosarcoma of the left fibula. Radiological studies showed minimal changes at the metadiaphyseal portion of the left tibia. Bone scans and MR studies were highly suggestive of necrosis of bone and muscle of the proximal end of the tibia. Multiple biopsies of the tibia at the time of excision and 2 years later showed histological features consistent with a slowly healing osteonecrosis of bone. Review of the literature reported transient pain and swelling after intraarterial chemotherapy but did not demonstrate the association with necrosis of bone and muscle. It can be anticipated that as intraarterial chemotherapy of malignant tumors of bone and soft tissues becomes more widely used, these complications will be observed more frequently.