Kumar Sarayu, Alazraki Adina, George Bradley, Martin Melissa, Katzenstein Howard M, Cash Thomas
*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.
J Pediatr Hematol Oncol. 2017 Nov;39(8):e446-e449. doi: 10.1097/MPH.0000000000000821.
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.
气胸是骨肉瘤一种广为人知的并发症。相反，据我们所知，纵隔气肿仅在1例骨肉瘤患者中被报道过，且该患者伴有可检测到的肺转移。我们报告1例18岁男性患者，其患有局限性远端股骨骨肉瘤，诊断时发现有无症状纵隔气肿和肺大疱，16个月后出现肺部复发。我们的病例表明，这些发现可能提示存在隐匿性转移疾病，并提醒医务人员要进行适当治疗并高度怀疑肺部复发，加强监测。
