technetium-tc-99m-medronate and Sarcoma--Synovial

Topics: Biopsy; Bone Density Conservation Agents; Bone Neoplasms; Calcinosis; Calcium; Diagnosis, Differential; Diphosphonates; Drug Therapy, Combination; Edema; Humans; Humerus; Imidazoles; Male; Middle Aged; Multimodal Imaging; Osteolysis, Essential; Positron-Emission Tomography; Radiopharmaceuticals; Sarcoma, Synovial; Scapula; Shoulder Joint; Technetium Tc 99m Medronate; Tomography, X-Ray Computed; Vitamin D; Zoledronic Acid

Metastatic osteosarcoma most commonly affects the lungs and other bones. Hepatic metastasis at the time of diagnosis is extremely rare. A 14-year-old boy with synovial sarcoma of the left popliteal fossa was treated with surgical resection, radiotherapy for microscopic residual disease, and 1 year of chemotherapy (vincristine, cyclophosphamide, dactinomycin, and doxorubicin). Approximately 10 years after the initial diagnosis, a secondary osteosarcoma developed in the left proximal tibia. Computed tomography at presentation showed bilateral pulmonary metastases and large ossified nodules in the liver that demonstrated abnormal avidity on 99mTc MDP bone scan indicating hepatic metastasis. Despite chemotherapy (cisplatin, ifosfamide, high-dose methotrexate, and dacarbazine), the patient died of progressive disease 4 months after the diagnosis of the second cancer. Hepatic metastasis was found at the time of diagnosis of a secondary osteosarcoma and manifested as ossified nodules. The risk of radiation-induced osteosarcoma should always be considered in decisions about treatment for soft-tissue sarcoma.

Topics: Adolescent; Fatal Outcome; Humans; Liver Neoplasms; Lung Neoplasms; Male; Neoplasms, Radiation-Induced; Neoplasms, Second Primary; Ossification, Heterotopic; Osteosarcoma; Radiopharmaceuticals; Radiotherapy; Sarcoma, Synovial; Technetium Tc 99m Medronate; Tomography, Emission-Computed

Topics: Female; Humans; Middle Aged; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium Tc 99m Medronate; Thigh

In a patient with synovial sarcoma, routine bone survey showed no abnormality, while bone marrow scintigraphy with Tc-99m sulfur colloid revealed a defect in the fifth lumbar vertebra. At surgery, tumorous invasion was noted in the fifth lumbar vertebra and the surrounding tissues. It was suggested that the bone marrow scintigraphy was particularly useful in the detection of tumorous invasion into the bone marrow at the early stage before the destruction of skeletal tissue.

Topics: Adolescent; Bone Marrow; Diphosphonates; Foot Diseases; Humans; Lumbar Vertebrae; Male; Neoplasm Metastasis; Radionuclide Imaging; Sarcoma, Synovial; Spinal Neoplasms; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Sulfur Colloid

Topics: Calcinosis; Child; Diphosphonates; Female; Humans; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate; Thigh

Topics: Adult; Aged; Diphosphonates; Humans; Liposarcoma; Male; Radionuclide Imaging; Sarcoma, Synovial; Soft Tissue Neoplasms; Technetium; Technetium Tc 99m Medronate