CTICasesAggressive Osteosarcoma with Pleural, Peritoneal, and Intravascular Metastases
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Imaging findings
Diffuse, high-density, calcified, and ossified soft tissue nodules extensively involving both pleural spaces, fissures, and the peritoneum, with associated retroperitoneal lymphadenopathy. Intravascular metastases are also evident, with some nodules expanding pulmonary arteries. These findings represent progression from initial pleural metastases diagnosed in 2012, following a secondary osteosarcoma in a prior Ewing sarcoma radiation field.
Key takeaways
This case illustrates a highly aggressive osteosarcoma, particularly notable for its widespread metastatic pattern including peritoneal and intravascular dissemination in addition to extensive pleural involvement. The presence of intravascular metastases, seen as lesions expanding within pulmonary arteries, is a recognized but severe manifestation of osteosarcoma spread.
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