Cardiovascular recurrence of high-grade osteosarcoma presenting as atrial thrombosis and pulmonary embolism: A case report and review of the pediatric literature

Abstract

In the era of neoadjuvant and adjuvant chemotherapy, extrapulmonary involvement by high-grade osteosarcoma (HGOS) is rare. Importantly however, HGOS metastasis in the form of cardiovascular tumor thrombus portends a dismal prognosis. Thus, prompt and accurate identification of tumor thrombus is crucial. We report here two unique cases of recurrent HGOS, presenting as thrombotic events, in order to increase awareness and index of suspicion among practitioners regarding this presentation. Additionally, we review 14 previously reported pediatric cases of cardiovascular metastatic HGOS.

Keywords:

• Osteosarcoma
• tumor thrombus
• cardiovascular metastasis

Acknowledgments

We would like to thank Karen W. Eldin, MD and Deborah A. Schady, MD for providing pathological diagnoses and images.

Disclosure statement

None of the authors have any conflicts of interest to report.