Palliative Radiation in Metastatic Osteosarcoma
The patient is an 18-year-old black woman presenting with osteosarcoma arising in the distal femur and metastasizing to the lungs. Multidrug chemotherapy with methotrexate, ifosfamide, and cisplatin for 5 months resulted in an initially good response, although doxorubicin (Adriamycin) had to be discontinued because of cardiac arrhythmia. A wide resection with knee joint replacement was accomplished but there was rather rapid recurrence, both locally in the femur and the lung. The patient had an above-the-knee amputation for the local recurrence and was started on ifosfamide for the pulmonary metastases. During the next 6 months the patient developed left leg paresis and urinary retention associated with an intramedullary metastasis at T11–12. Further data is not provided regarding the response of the pulmonary metastases to ifosfamide, but on physical examination the patient was noted to be cachectic and on nasal oxygen.
KeywordsSpinal Cord Brain Stem Glioma Metastatic Osteosarcoma Knee Joint Replacement Multidrug Chemotherapy
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