DOI QR코드

DOI QR Code

Late Relapse of an Osteosarcoma Presenting as a Gastric Mass

위의 종괴 양상으로 재발한 골육종 1예

  • Park, Ha-Na (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Jun-Young (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Eun-Young (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Eun-Jung (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Gil-Sun (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Eun-Jung (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Min, Byung-Hoon (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 박하나 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 박준영 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 이은영 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 박은정 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 이길선 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 김은정 (성균관대학교 의과대학 삼성서울병원 내과) ;
  • 민병훈 (성균관대학교 의과대학 삼성서울병원 내과)
  • Published : 2012.07.01

Abstract

Metastasis of osteosarcoma to the gastrointestinal tract is very rare. However, since the introduction of intensive adjuvant chemotherapy, the number of reported cases of gastrointestinal metastasis has been increasing in patients with osteosarcoma. Only three cases of gastric metastasis have been reported to date, and no case has been reported in Korea. Delayed metastasis long after successful treatment can also occur in osteosarcoma, particularly in patients who receive adjuvant chemotherapy and radical surgery. Hence, the possibility of gastrointestinal metastasis needs to be considered in the differential diagnosis when patients with osteosarcoma present with gastrointestinal symptoms, such as melena or hematochezia, long after successful treatment, including chemotherapy. Here, we report a recurrent osteosarcoma presenting as gastric metastasis in a patient who underwent a radical limb salvage operation followed by adjuvant chemotherapy and who had no evidence of recurrent disease for 11 years.

골육종의 위장관 전이는 매우 드물다. 그러나 보조적 항암치료의 도입 이후 골육종의 위장관 전이가 보고되고 있는데 그 중에서도 위전이는 전 세계적으로 3예만 보고되었고 국내에서는 보고된 바가 없다. 또한 수술과 함께 보조적 항암치료를 받은 골육종 환자에서 치료 종료 후 오랜 기간이 지난 후에 발생한 지연성 재발이 보고되고 있다. 따라서 오래 전에 항암치료를 포함한 골육종 치료를 받은 환자에서 혈변이나 흑변과 같은 위장관 증상이 새로이 발생했을 때, 치료 후 장기간 동안 재발이 없었다 하더라도 골육종의 위장관 전이 가능성을 고려해야 할 것이다. 저자들은 대퇴부 골육종을 진단받고 수술 및 항암치료 후 11년간 재발이 없었던 환자에서 발생한 위전이 재발의 증례를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Whelan JS. Osteosarcoma. Eur J Cancer 1997;33:1611-1618. https://doi.org/10.1016/S0959-8049(97)00251-7
  2. La Quaglia MP. Osteosarcoma: specific tumor management and results. Chest Surg Clin N Am 1998;8:77-95.
  3. Horiuchi K, Susa M, Mukai M, et al. Osteosarcoma with metastasis to the stomach. J Orthop Sci 2010;15:265-268. https://doi.org/10.1007/s00776-009-1435-7
  4. Strong VE, Shalkow J, Antonescu CR, Meyers P, La Quaglia MP. Osteosarcoma with delayed metastasis to the stomach. J Pediatr Surg 2007;42:737-739. https://doi.org/10.1016/j.jpedsurg.2006.12.005
  5. Overberg-Schmidt US, Baumgarten E, Bassir C, Becker M, Unger M, Henze G. The stomach and pulmonary interlobular space as unusual sites of osteosarcoma. Pediatr Hematol Oncol 1999;16:61-66. https://doi.org/10.1080/088800199277614
  6. Jeffree GM, Price CH, Sissons HA. The metastatic patterns of osteosarcoma. Br J Cancer 1975;32:87-107. https://doi.org/10.1038/bjc.1975.136
  7. Giuliano AE, Feig S, Eilber FR. Changing metastatic patterns of osteosarcoma. Cancer 1984;54:2160-2164. https://doi.org/10.1002/1097-0142(19841115)54:10<2160::AID-CNCR2820541016>3.0.CO;2-P
  8. Kim JS, Cho BJ, Rhee MS, Yang YK. A case of secondary osteogenic sarcoma of the heart. Korean J Med 1967;10:131-134.
  9. Hauben EI, Bielack S, Grimer R, et al. Clinico-histologic parameters of osteosarcoma patients with late relapse. Eur J Cancer 2006;42:460-466. https://doi.org/10.1016/j.ejca.2005.09.032
  10. Bacci G, Ruggieri P, Picci P, et al. Changing pattern of relapse in osteosarcoma of the extremities treated with adjuvant and neoadjuvant chemotherapy. J Chemother 1995; 7:230-239.