Awwad Habeeb H, Assi Anas K, Khaled Zaina A, Owienah Haneen, Abulilhya Mohand, Azzam Khaled S, Bashir Bahaa, Sweileh Thaer, Eleyan Feras
Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
Radiology Department, Istishari Arab Hospital, Ramallah, West Bank, Palestine.
Ann Med Surg (Lond). 2025 May 26;87(7):4578-4584. doi: 10.1097/MS9.0000000000003383. eCollection 2025 Jul.
The most prevalent malignant bone tumor that typically impacts young adults is osteosarcoma. Synchronous multifocal osteosarcoma (SMOS) with metastasis is extremely rare, defined by the occurrence of various bone lesions being presented at the time of diagnosis. This report describes a rare case of SMOS with adrenal involvement and a simultaneous abdominal aortic aneurysm (AAA).
We report a case of a 34-year-old Palestinian male with a history of hypertension and gout who presented with lower back and right leg pain. Imaging studies showed multiple lytic lesions in the lumbar spine, pelvis, and femur, confirming the presence of a metastatic disease. A whole-body CT scan revealed an adrenal mass and an AAA. A core needle biopsy confirmed the diagnosis of high-grade SMOS with metastasis.
Osteosarcoma is the primary cancerous bone tumor that frequently impacts teenagers and young adults. Although multifocal osteosarcoma is rare, it is characterized by its aggressive nature and its possibility to metastasize. SMOS, which is a less common type, makes up only 0.6% of cases. Metastatic SMOS commonly impacts bones, including the pelvis, spine, and femur. While it is typical for cancer to spread to places like the lungs, the rare occurrence of metastasis to organs like the adrenal glands makes diagnosis and treatment more challenging.
This case highlights the challenges in diagnosing and managing SMOS with unusual metastatic patterns and significant comorbidities. It emphasizes the importance of using interdisciplinary, comprehensive methods to optimize patient outcomes in such clinical scenarios.
骨肉瘤是最常见的通常影响年轻人的恶性骨肿瘤。伴有转移的同步多灶性骨肉瘤（SMOS）极为罕见，其定义为在诊断时出现各种骨病变。本报告描述了一例罕见的伴有肾上腺受累及同时存在腹主动脉瘤（AAA）的SMOS病例。
我们报告一例34岁的巴勒斯坦男性，有高血压和痛风病史，因腰背部和右腿疼痛就诊。影像学检查显示腰椎、骨盆和股骨有多个溶骨性病变，证实存在转移性疾病。全身CT扫描显示肾上腺肿块和腹主动脉瘤。粗针穿刺活检确诊为伴有转移的高级别SMOS。
骨肉瘤是常见的原发性骨癌，常影响青少年和年轻人。虽然多灶性骨肉瘤很少见，但其具有侵袭性且有可能发生转移。SMOS是一种较不常见的类型，仅占病例的0.6%。转移性SMOS通常累及骨骼，包括骨盆、脊柱和股骨。虽然癌症通常会转移到肺部等部位，但罕见的转移至肾上腺等器官的情况使得诊断和治疗更具挑战性。
本病例凸显了诊断和管理具有不寻常转移模式及显著合并症的SMOS的挑战。它强调了在这种临床情况下采用跨学科、综合方法以优化患者治疗效果的重要性。
