Recurrent Alveolar Soft Part Sarcoma on Bone Scintigraphy.

Area of Science:

• Oncology
• Radiology
• Orthopedic Surgery

Background:

• Alveolar soft part sarcoma (ASPS) is a rare, malignant soft tissue tumor typically affecting young adults.
• Surgical resection is the primary treatment for localized ASPS.
• Recurrence can occur, necessitating vigilant follow-up and diagnostic imaging.

Observation:

• A 15-year-old female presented with localized thigh swelling and tenderness a year after surgical resection of ASPS.
• The patient underwent Technetium-99m methylene diphosphonate (Tc-99m MDP) bone scintigraphy to assess for potential bone metastases.
• Scintigraphy revealed abnormally increased radiotracer uptake in the region of the prior tumor excision site.

Findings:

• Tc-99m MDP bone scintigraphy identified increased activity suggestive of local recurrence or residual disease at the site of the resected alveolar soft part sarcoma.
• No evidence of osseous metastases was detected on the bone scan.
• The imaging finding correlated with the patient's reported symptoms of local tenderness and swelling.

Implications:

• Tc-99m MDP bone scintigraphy can be a valuable tool in detecting local recurrence of alveolar soft part sarcoma, even in the absence of bone metastases.
• Early detection of local recurrence allows for timely intervention and management.
• This case highlights the importance of considering local recurrence in patients with a history of ASPS presenting with new-onset localized symptoms.