Parosteal Osteosarcoma with Pancreatic Metastasis and Multiple Relapses: A Case Report and Comparison with the Literature

Abstract

Background: Osteosarcoma is the most common primary bone cancer in all age groups. Metastasis mostly occurs with high-grade tumors disseminating to the lungs and other bones. Spread to the pancreas is extremely rare and is undocumented in the low-grade histologic subtype of parosteal osteosarcoma. Additionally, it is uncharacteristic of the disease course of parosteal osteosarcoma to involve multiple local and pulmonary relapses.

Observation: We present a 35 year-old African American woman with parosteal osteosarcoma who has experienced an atypical metastasis to the pancreas as well as multiple local and pulmonary relapses. The lesion was identified incidentally on routine chest imaging, and the patient underwent distal pancreatectomy. We compare our case to the few other reports of pancreatic metastasis in the literature.

Conclusion: Despite being especially rare, clincians ought to be aware of pancreatic metastasis of osteosarcoma. We present a case exemplifying this phenomenon in the prognostically favorable histologic subtype of parosteal osteosarcoma.