Abstract
A 16-year old female presented painful masses in the lumbar region 5 years after the initial diagnosis of a localized osteosarcoma of the tibia. Abdominal X-ray revealed calcified masses. A bone scan confirmed an increased uptake in the renal areas. An ultrasound-guided fine needle biopsy confirmed the diagnosis of metastases. The procedure was complicated by subcapsular hemorrhage and gross hematuria. Renal metastases from osteosarcoma are usually asymptomatic and invisible on abdominal X-rays. The diagnosis is generally established by radionuclide bone scan or abdominal CT-scan. Our observation suggests that histological documentation of these unusual clinical presentations should be carefully weighed against the risk of the procedure.
(c) 2007 Wiley-Liss, Inc.
MeSH terms
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Amputation, Surgical
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Biopsy, Fine-Needle / adverse effects*
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Bone Neoplasms / surgery*
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Calcinosis / diagnostic imaging
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Calcinosis / etiology
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Camptothecin / analogs & derivatives
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Camptothecin / therapeutic use
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Child
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Combined Modality Therapy
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Doxorubicin / administration & dosage
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Fatal Outcome
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Female
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Hematuria / etiology
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Hemorrhage / etiology*
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Humans
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Iatrogenic Disease
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Ilium / pathology
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Irinotecan
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Kidney Neoplasms / diagnostic imaging
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Kidney Neoplasms / pathology
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Kidney Neoplasms / secondary*
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Lung Neoplasms / drug therapy
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Lung Neoplasms / secondary
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Lung Neoplasms / surgery
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Methotrexate / administration & dosage
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Osteosarcoma / drug therapy
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Osteosarcoma / secondary*
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Osteosarcoma / surgery
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Radiography
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Tibia* / pathology
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Tibia* / surgery
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Ultrasonography, Interventional
Substances
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Irinotecan
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Doxorubicin
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Camptothecin
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Methotrexate