Multiple

Ossified

Downloaded from www.ajronline.org by 117.253.232.74 on 11/09/15 from IP address 117.253.232.74. Copyright ARRS. For personal use only; all rights reserved

CHARLES

We

recently

tastases sarcoma. to the of

a patient

the

kidneys

and

easily

the

English

of multiple to

GOLDSTEIN,1

with from

MARJORIE

multiple a

to the A.

ossified

primary

Kidney

identified

ossified

on

literature

me-

renal

films.

metastases

no

panenchyma

A.

kidneys

(fig.

the

calcified

and

represented

Sarcoma

BOSNIAK

1 ). An

intravenous

densities

urognam

were

multiple

within

ossified

ne-

the

renal

metastases

in

both kidneys. Uninanalysis was negative throughout the patient’s course, and he died 3 months later of widespread metastatic disease. No autopsy was performed.

case

demonstrated

that

Osteogenic

MORTON

the

vealed

A re-

similar

AND

overlying

osteogenic

abdominal

revealed

from

AMBOS,

A radiographic diagnosis of metastatic disease kidneys was possible because the lesions were

ossified view

studied to

Metastases

prior

Discussion

autopsy. Osteogenic Case

10-30

Report

lion,

A 25-year-old white male entered New York University Hospital for follow-up evaluation in December 1975. Three years earlier, he was seen with a sclerotic lesion of the distal right femur which on biopsy was found to be osteogenic sarcoma. No metastatic disease was found and a radical resection of the distal night femur was performed with insention of a Wandius prosthesis. The patient remained well until

3

months

tastatic lesion

the

prior

nodules in

his

pulmonary

were thoracic

to

the

present

found spine.

metastases

in On

and

admission

both

lungs

admission,

calcified

when

and

a

densities

age

commonly from

5%

5

to

19%

Metastases

noted

vive

long

sites

year [4,

peak

occurrence

of two

[1].

humerus With rate

per

the mil-

[1-3].

The

the

most

radiation

surgery

ranges

5]. osteogenic

[2-4]. since to

are

on without after

sarcoma

route. Most frequent at autopsy; other bones,

enough

in

to three

predominance

and

survival

from

12% at autopsy in vivo is rare,

of

male

tibia,

involved

a

at a rate

a decided upper

the

hematogenous lungs, 95%

has

group

with

femur,

therapy,

me-

were

and

lower

blastic

progression

sarcoma

year

The finding the patient develop

spread

metastatic 50%; and

via

the

sites are kidneys,

of kidney metastases usually does not sun-

symptoms.

1I’_

.

Received I

to Am

July

All authors:

29,

1976;

Department

accepted

,.

after

of Radiology,

revision New

York

September University

28,

1976.

Medical

Center.

M. A. Ambos.

J Ro.ntg.nol

128:148-149,

January

1977

148

550

First

Avenue

.

New

York,

New

York

1001 6. Address

reprint

requests

CASE

Willis

[6]

kidneys

reported

occurs

malignancies.

Downloaded from www.ajronline.org by 117.253.232.74 on 11/09/15 from IP address 117.253.232.74. Copyright ARRS. For personal use only; all rights reserved

tive

the

graphically, or

have

sarcoma

trate

as

who 10

a large

focus

et al. pole

had

metastatic

a kidney

kidney.

Our

case

Drake pole

was

4 months

found

[10] of the

mass

[10,

illus-

the

6. 7.

8.

Nelson an

lower

9.

osteo-

This patient died a large metastatic

involving

5.

thigh

revealed in the

after

been removed. and at autopsy

[Am]

localized ossified

sarcoma.

calcified

been

Dahlin D, Coventry M: Osteogenic sarcoma: a study of 600 cases. J Bone Joint Surg [Am] 49:101-1 10, 1967 2. Johnson A, Bonfiglio M, Cooper A: Osteosarcoma. Clin Orthop 78:314-322, 1971 3. Price CHG, Jeffree GM: Metastatic spread of osteosarcoma. Br J Cancer 28:515-524, 1973 4. McKenna A, Schwinn C, Soong KY, Higinbotham N: Sarcomata of the osteogenic series. J Bone Joint Surg

of a kidney

nephrectomy

osteogenic

discovered

sarcoma

the

and

sarcoma A

a large

patients

upper

of

osteogenic

solitary or smaller

an osteogenic

sarcoma had after surgery,

osteogenic

in the

previously.

[1 1] described of

genic soon

of

Marshall

be with

not

of

in living

were multiple

may

histology

have

REFERENCES 1.

Angio-

findings

reports

kidneys

lesions than mass

years

the

lower

pole

with

mul-

10.

11. appears

to

be

tiple widespread osteogenic sarcoma.

ossified There

nostic

on

appearance

the renal was

urography.

first

reported

metastases a distinctive

I 49

the nega-

size.

kidney

on

other

case.

calcified

in a patient

the

sarcoma

to the

in our

a 9 cm

is usually

Angiographic

two

metastatic

removed

of

been

to

of widespread

a large

to

osteogenic

In both cases the masses rather

nodules,

to

depending [7-9].

from

described. There

cases

grow lesions

lesion

metastases

disease dying

in these

hypovascular

primary

metastatic patients

metastases

metastatic

vascular

I 1]. large

of

Urography

unless

the

that

in 7.6%

REPORTS

from an and diag-

48:1-26,

1966

Weinfeld MS. Dudley HA: Osteogenic sarcoma. J Bone Joint Surg [Am] 44:269-276, 1962 Willis RA: The Spread of Tumor in the Human Body. London, Butterwonth, 1952 Lucke B, Shlumbenger HG: Atlas of Tumor Pathology, section 8. Washington, D.C., Armed Forces Institute of Pathology, 1957 Kahn PC, Wise HR: The use of epinephnine in selective angiography of renal masses. J Urol 99:133-138, 1968 Shimkin PM, Buchignani JS, Soloway MS: Blood borne metastases to the kidney. Acta Radio! [Diagn] 12:387395, 1972 Marshall D, Drake E: Transthoracic nephrectomy for metastatic osteogenic sarcoma of the kidney. J Maine Med Assoc 41:320-323, 1950 Nelson JA, Clank A, Palubinskas AJ: Osteogenic sarcoma with calcified renal metastasis. Br J Radio! 44: 802-804,

1971