A Case of Metastatic Extraskeltal Osteosarcoma of Small Intestine with Intussusception

Hideki Sakisaka, Kohei Murata, Masao Kameyama, Yuichiro Doki, Hiroaki Ohigashi, Masahiro Hiratsuka, Yo Sasaki, Osamu Ishikawa, Masayuki Mano^* and Shingi Imaoka

Department of Surgery, Department of Pathology^* Osaka Medical Center for Cancer and Cardiovascular Diseases

A 47-year-old woman had an extended excision of subcutaneous soft tissue tumor at the left thigh 2 years and 8 months earlier. Eight months earlier, she had partial resection of S8 in the right lung for a metastatic lesion from the thigh tumor. During examination for anemia, she suffered intussusception necessitating surgery. It was intussusception that tumor had intussuscepted at the ileum to the transverse colon, necessitating right hemicolectomy. The 56×45×36mm polypoid tumor was 15cm oral from the Bauhin valve. Hisotopathological examination showed abundant tumorous osteoid formation and the diagnosis was osteosarcoma. Because we could hardly find any osteoid formation in the left thigh tumor and the S8 right lung lesion, the initial diagnosis for these tumors was malignant fibrous histiocytoma. After a review of the 3 tumors by multiple pathologists, we concluded that the diagnosis was extraskeltal osteosarcoma and the tumor originally developed at the subcutaneous area, metastasized to the lung, and then to the intestine. After 2 months, the patient had recurrence at multiple sites and died of this disease at 4 months after the surgery. Extraskeltal osteosarcoma is a rare malignant soft tissue tumor usually arising in adults and that bodes a poor prognosis. It frequently metastasizes to the lung, but metastasis to small intestine is rare. This is only the sixth such report to our knowledge.

Key words
metastatic extraskeletal osteosarcoma, intussusception, small intestine

Reprint requests
Kohei Murata Department of Surgery, Osaka Medical Center for Cancer and CVD 1-3-3 Nakamichi, Higashinari, Osaka, 537-8511 JAPAN

Accepted
May 1, 2002

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