Basu Sandip, Shet Tanuja, Awasare Sushama
Radiation Medicine Centre, Bhabha Atomic Research Centre, Bombay, India.
Hell J Nucl Med. 2009 Jan-Apr;12(1):51-4.
Adrenal gland involvement as well as metastatic subcutaneous nodule from skeletal osteosarcoma are two extremely rare and unusual manifestations in the natural history of the disease. We herein report a 45 yr old female with both these uncommon occurrences, having large bilateral adrenal metastases and a metastatic subcutaneous nodule in fluorine-18 fluorodesoxy glucose- positron emission tomography the chest wall along with pulmonary metastasis arising from osteosarcoma of the mandible. Our (18)F-FDG-PET study provided all information needed about the disease status in a single examination. It is noteworthy that osteosarcoma of the jaws, thought to be relatively less aggressive compared to its counterpart in long bones, can occasionally give rise to widespread metastases, including atypical sites. A systematic review of the existing literature aiming to explore the patients' characteristics and clinical behavior of adrenal metastases from osteosarcoma, including the present case, was carried out. This was nearly always associated with pulmonary metastases with occasional association with brain or skeletal metastases. Peripheral long bones were the overwhelmingly common site of the primary, the present one being the first report of jaw bone being the primary site, giving rise to adrenal metastases. No age predilection was observed with male to female ratio of 3:1 in the small number of reported cases.
肾上腺受累以及骨骼骨肉瘤的转移性皮下结节是该疾病自然病程中极为罕见和不寻常的表现。我们在此报告一名45岁女性，同时出现了这两种罕见情况，在氟-18氟脱氧葡萄糖正电子发射断层扫描中显示双侧肾上腺有大的转移灶、胸壁有一个转移性皮下结节以及下颌骨肉瘤引起的肺转移。我们的（18）F-FDG-PET研究在一次检查中提供了有关疾病状态所需的所有信息。值得注意的是，颌骨骨肉瘤被认为与长骨骨肉瘤相比侵袭性相对较小，但偶尔也会导致广泛转移，包括非典型部位。我们对现有文献进行了系统回顾，旨在探讨骨肉瘤肾上腺转移患者的特征和临床行为，包括本病例。肾上腺转移几乎总是与肺转移相关，偶尔与脑或骨转移相关。外周长骨是最常见的原发部位，本病例是颌骨作为原发部位导致肾上腺转移的首例报告。在少数报告病例中未观察到年龄偏好，男女比例为3:1。
