Radionuclide detection of primary pulmonary osteogenic sarcoma: a case report and review of the literature.

A healthy elderly white man was admitted for right inguinal herniorrhaphy. Preoperative chest x-ray revealed a large mass in the lower lobe of the left lung. CT-directed needle biopsy was nondiagnostic. Technetium-99m methylene diphosphonate (99mTc-MDP) bone scan revealed intense soft-tissue activity in the lower left hemithorax with no evidence of abnormal activity in the osseous skeleton. Because of the degree of uptake in the lesion, a presumptive diagnosis of extraosseous osteogenic sarcoma was made. The patient had a left lower lobectomy and the lesion was diagnosed as an osteosarcoma of primary pulmonary origin.