Multicentric osteosarcoma with long-term survival

We present a 14-year-old girl with multicentric osteosarcoma who has survived for over 9 years to date. The patient first noticed right knee pain in 1992. Radiographs showed a destructive and sclerotic lesion of the right distal femur. Similar small sclerotic lesions were seen in the proximal metaphysis of the right femur, proximal site of the right humerus, and mid-posterior of the left humerus. A diagnosis of multicentric osteosarcoma was made on a biopsy of the right distal femur. The sclerotic lesions of the bilateral humeri disappeared after systemic chemotherapy (T-20), and thus wide excisions of the right distal femur and proximal femur were performed in 1993. New lesions appeared in the left iliac bone and the first lumbar vertebra on bone scintigraphy 24 months after the first surgery. Chemotherapy and wide excisions of the left iliac bone and the first lumbar vertebra were performed. The patient was well at the latest follow-up in April 2003, with no evidence of local recurrence or distant metastasis, but recently renal dysfunction appeared.