A case report of osteogenic sarcoma with leprosy

Area of Science:

• Oncology
• Infectious Diseases
• Dermatology

Background:

• Osteosarcoma is a primary malignant bone tumor, often affecting adolescents and young adults.
• Leprosy, a chronic infectious disease caused by Mycobacterium leprae, primarily affects the skin, peripheral nerves, and upper respiratory tract.
• The co-occurrence of osteosarcoma and leprosy is exceptionally rare, presenting unique diagnostic and therapeutic challenges.

Observation:

• A 15-year-old male presented with a right knee mass, diagnosed as osteosarcoma.
• Following the first cycle of adjuvant chemotherapy (ACT), the patient developed symptoms consistent with leprosy, including fever, skin nodules, ear perichondritis, and nerve thickening.
• Slit-skin smear examination confirmed the presence of acid-fast bacilli, leading to a diagnosis of multibacillary leprosy.

Findings:

• The patient received concurrent treatment for both osteosarcoma and leprosy.
• Anti-leprosy medications and steroids were administered for leprosy, while ACT was resumed after stabilization.
• The patient achieved complete resolution of his skin lesions during follow-up.

Implications:

• This case highlights the importance of considering opportunistic infections, such as leprosy, in immunocompromised patients undergoing chemotherapy.
• It underscores the feasibility of managing co-existing malignancies and infectious diseases with a multidisciplinary approach.
• Early recognition and integrated treatment strategies are crucial for successful outcomes in patients with rare dual diagnoses.