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LETTER TO THE EDITOR |
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Year : 2011 | Volume
: 7
| Issue : 2 | Page : 229-230 |
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Solitary anterior abdominal wall metastasis from osteogenic sarcoma of fibula as detected by FDG-PET imaging
Sandip Basu1, Sangeeta B Desai2
1 Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Mumbai, Maharashtra, India 2 Department of Pathology, Tata Memorial Hospital, Mumbai, Maharashtra, India
Date of Web Publication | 12-Jul-2011 |
Correspondence Address: Sandip Basu Radiation Medicine Centre (BARC), Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai - 400 012, Maharashtra India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-1482.82935
How to cite this article: Basu S, Desai SB. Solitary anterior abdominal wall metastasis from osteogenic sarcoma of fibula as detected by FDG-PET imaging. J Can Res Ther 2011;7:229-30 |
How to cite this URL: Basu S, Desai SB. Solitary anterior abdominal wall metastasis from osteogenic sarcoma of fibula as detected by FDG-PET imaging. J Can Res Ther [serial online] 2011 [cited 2022 May 26];7:229-30. Available from: https://www.cancerjournal.net/text.asp?2011/7/2/229/82935 |
Sir,
An unusual case of osteosarcoma with metastasis to the subcutaneous lump in the abdominal wall is presented. The patient, a 21-year-old female, who was diagnosed to have osteogenic sarcoma of the left fibula, had undergone left fibulectomy 3 years previously. She presented with a recent onset feeling of circumscribed hardening of the anterior abdominal wall. FDG-PET study was undertaken for whole body disease survey, which demonstrated two foci of abnormal uptake, one of which corresponded to the area of hardening and the uptake was through the skin and subcutaneous tissue [Figure 1]a and b. Another tiny focus of abnormal FDG uptake was noted just posterior and superior to the urinary bladder [Figure 1]a and b, which persisted in the delayed imaging. A tissue diagnosis was sought for in view of a very unusual site of disease recurrence for osteosarcoma, which proved the fair-sized lesion in the anterior abdominal wall noted in the FDG-PET to be a metastasis from osteosarcoma [Figure 2]a and b.  | Figure 1: Whole body FDG-PET. (a) baseline image (carried out 60 min after the intravenous injection of 300 MBq of 18F-FDG) and (b) delayed image shows a fair-sized focus of avid FDG uptake in the anterior abdominal wall (evident in the sagittal slices)
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 | Figure 2: (a) Core biopsy showing malignant cells infi ltrating fat; (b) higher power demonstrates the pleomorphic spindle cells with hyaline osteoid matrix
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The case upholds the fact that recurrences at unusual sites can occur after an apparent prolonged disease-free survival and underscores the importance of regular and long-term follow-up with whole body FDG-PET in this setting. Functional imaging plays pivotal role in monitoring disease activity [1] and can aid in detecting and monitoring unusual sites of metastases in osteosarcoma [2],[3] or unusual primary osteosarcomas of the soft tissue organ. [4] The whole body evaluation is a distinct advantage of FDG-PET in this regard. We have previously reported isolated breast metastasis and adrenal metastasis in the setting of osteosarcoma [2],[3] where such functional imaging played a critical role in detecting the metastatic disease at unusual sites. The present case is a useful addition to these reports.
> References | |  |
1. | Franzius C, Sciuk J, Brinkschmidt C, Jürgens H, Schober O. Evaluation of chemotherapy response in primary bone tumors with F-18 FDG positron emission tomography compared with histologically assessed tumor necrosis. Clin Nucl Med 2000;25:874-81.  |
2. | Basu S, Shet T, Awasare S. Bilateral adrenal metastases and metastatic subcutaneous deposit in the chest wall from osteosarcoma of the mandible: Utility of 18 F-FDG-PET. Hell J Nucl Med 2009;12:51-4.  [PUBMED] |
3. | Basu S, Moghe SH, Shet T. Metastasis of humeral osteosarcoma to the contralateral breast detected by 99mTc-MDP skeletal scintigraphy. Jpn J Radiol 2009;27:455-7.  |
4. | Makis W, Novales-Diaz JA, Hickeson M. Primary thyroid osteosarcoma: Staging and evaluation of response to therapy with F-18 FDG PET-CT. Clin Nucl Med 2010;35:517-20.  [PUBMED] [FULLTEXT] |
[Figure 1], [Figure 2]
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