CTICasesRecurrent Spine Osteosarcoma with Pleural Metastasis
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Imaging findings
Initial thoracic spine imaging shows an abnormal osteolytic and bone-forming mass on the left side of the thoracic spine. Following partial surgical resection, serial CT scans demonstrate progressive local recurrence within the vertebral body and subsequent development of a small, calcified focus within the anterior mediastinal fat and pleural surface of the left hemithorax. Over a three-year period, these lesions demonstrate slow but inexorable growth, developing into a massive calcified mediastinal and pleural-based tumor.
Key takeaways
Osteosarcoma of the spine is a rare, aggressive malignancy that is difficult to completely resect. Recurrence can present as slowly growing, highly calcified or osteoid-forming masses along the pleural surface or within the mediastinal fat, which may represent direct pleural seeding or localized spread following prior surgical intervention.
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