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Cardiopulmonary metastatic lesions of osteosarcoma and associated cerebral infarction
A H Limper1, U B Prakash, E Kokmen
1Division of Thoracic Diseases, Mayo Clinic, Rochester, MN 55905.
Insights
Osteogenic sarcoma can spread to the brain, causing stroke. This case highlights a rare instance of a patient experiencing cerebral infarction due to metastatic osteogenic sarcoma emboli.
Area of Science:
- Oncology
- Neurology
- Cardiology
Background:
- Osteogenic sarcoma commonly metastasizes hematogenously.
- Cerebral infarction is a rare complication of thoracic osteogenic sarcoma metastases.
Observation:
- A 32-year-old presented with acute cerebral infarction.
- Cardiac auscultation revealed an abnormal diastolic sound.
- Echocardiography identified a large left atrial mass.
Findings:
- The left atrial mass was confirmed as metastatic osteogenic sarcoma.
- Cerebral CT scans showed new metastatic lesions.
- The cerebral infarction was attributed to tumor embolization.
Implications:
- This case underscores the potential for unusual presentations of osteogenic sarcoma metastasis.
- Highlights the importance of considering embolic events in stroke patients with a history of malignancy.
- Emphasizes the catastrophic neurological complications of advanced osteogenic sarcoma.
Abstract:
Osteogenic sarcoma frequently disseminates by hematogenous routes. A 32-year-old patient underwent evaluation for an acute cerebral infarction. Cardiac auscultation disclosed an abnormal diastolic sound. Echocardiographic examination revealed a large left atrial mass, which was found at thoracotomy to be metastatic osteogenic sarcoma. Cerebral computed tomographic scans at the time of initial examination and 3 months later demonstrated new cerebral lesions consistent with metastatic growths. The abrupt cerebral infarction, other clinical findings, and results of diagnostic studies strongly suggested that the acute cerebrovascular event was the result of metastatic cerebral embolization from the tumor material found in the thorax. Cerebral infarction is an unusual and catastrophic complication of thoracic metastatic lesions of osteogenic sarcoma.