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Pulmonary Relapse of Osteosarcoma Following Presentation With a Pneumomediastinum and Localized Disease at Diagnosis

Kumar, Sarayu BS*; Alazraki, Adina MD; George, Bradley MD; Martin, Melissa CPNP§; Katzenstein, Howard M. MD; Cash, Thomas MD, MSc

Journal of Pediatric Hematology/Oncology: November 2017 - Volume 39 - Issue 8 - p e446–e449
doi: 10.1097/MPH.0000000000000821
Online Articles: Clinical and Laboratory Observations

Pneumothorax is a well-described complication of osteosarcoma. Conversely, the presence of a pneumomediastinum to our knowledge has been reported just once in a patient with osteosarcoma, and never without detectable lung metastasis. We report the case of an 18-year-old male with a localized, distal femur osteosarcoma who was found to have an asymptomatic pneumomediastinum and pneumatocele at diagnosis, and then 16 months later experienced a pulmonary relapse. Our case suggests that these findings may represent the presence of occult metastatic disease and cautions providers to treat appropriately and provide surveillance with a high index of suspicion for pulmonary recurrence.

*Emory University School of Medicine

Departments of Radiology and Imaging Sciences

Pediatrics, Emory University, Children’s Healthcare of Atlanta

§Children’s Healthcare of Atlanta, Atlanta, GA

Department of Pediatrics, Vanderbilt University, Monroe Carell Jr Children’s Hospital at Vanderbilt, Nashville, TN

Presented at the 2013 American Society of Pediatric Hematology Oncology (ASPHO) Conference in Miami, FL.

The authors declare no conflict of interest.

Reprints: Thomas Cash, MD, MSc, Department of Pediatrics, Emory University, Children's Healthcare of Atlanta, Health Sciences Research Building, Brumley Bridge, 3rd Floor, W-350, 1760 Haygood Drive, Atlanta, GA 30322 (e-mail:

Received October 14, 2016

Accepted February 13, 2017

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