Paraplegia Caused by Multifocal Osteosarcoma With Spinal Lesions

Area of Science:

• Oncology
• Orthopedic Surgery
• Radiology

Background:

• Multifocal osteosarcoma, a rare bone cancer, can occur synchronously or metachronously.
• Spine involvement in multifocal osteosarcoma is exceptionally uncommon.
• Synchronous multifocal osteosarcoma is defined by multiple tumor sites without pulmonary metastases.

Purpose of the Study:

• To report a rare case of multifocal osteosarcoma with extensive spinal involvement.
• To illustrate the diagnostic and management challenges associated with this condition.
• To emphasize the severe clinical consequences of spinal cord compression.

Main Methods:

• A 55-year-old male presented with low back pain and was diagnosed with multifocal osteosarcoma.
• Imaging revealed osteosclerotic lesions in the spine, pelvis, and soft tissues.
• Elevated alkaline phosphatase (ALP) levels were noted, and chemotherapy was initiated post-biopsy.

Main Results:

• Surgical decompression and spinal stabilization were performed due to spinal cord compression.
• Despite treatment, progressive lesions led to paraplegia and urinary dysfunction.
• The patient ultimately died from multiple organ failure 11 months after initial presentation.

Conclusions:

• Multifocal osteosarcoma with spinal lesions presents a significant clinical challenge.
• Spinal involvement can rapidly progress, leading to devastating neurological deficits like paraplegia.
• This condition severely compromises patients' quality of life and daily activities.