Primary Hepatic Osteosarcoma: A Rare Cause of Primary Liver Tumor

Relapsed primary extraskeletal osteosarcoma of liver: A case report and review of literature

BACKGROUND

Extraskeletal osteosarcoma (ESOS) is a highly malignant osteosarcoma that occurs in extraskeletal tissues. It often affects the soft tissues of the limbs. ESOS is classified as primary or secondary. Here, we report a case of primary hepatic osteosarcoma in a 76-year-old male patient, which is very rare.

CASE SUMMARY

Here, we report a case of primary hepatic osteosarcoma in a 76-year-old male patient. The patient had a giant cystic-solid mass in the right hepatic lobe that was evident on ultrasound and computed tomography. Postoperative pathology and immunohistochemistry of the mass, which was surgically removed, suggested fibroblastic osteosarcoma. Hepatic osteosarcoma reoccurred 48 d after surgery, resulting in significant compression and narrowing of the hepatic segment of the inferior vena cava. Consequently, the patient underwent stent implantation in the inferior vena cava and transcatheter arterial chemoembolization. Unfortunately, the patient died of multiple organ failure postoperatively.

CONCLUSION

ESOS is a rare mesenchymal tumor with a short course and a high likelihood of metastasis and recurrence. The combination of surgical resection and chemotherapy may be the best treatment.

Primary Exophytic Extraskeletal Osteosarcoma of the Liver: A Case Report and Literature Review

Introduction

Primary hepatic extraskeletal osteosarcoma (ESOS) is a rare tumor with no specific clinical manifestations, and little is known about it. Here, we describe an elderly patient with primary hepatic osteosarcoma confirmed by pathology results to raise awareness.

Case Report

We report an unusual case of a 62-year-old man who presented with right upper quadrant pain. The inflammatory indicators were elevated, and alkaline phosphatase (AKP), carbohydrate antigen (CA-199 and CA-125) were slightly increased. Computed tomography images and magnetic resonance images discovered a 7.8 × 7.4 × 6.6 cm mass with irregular radiated and cotton-like tumor bone between the liver and right kidney space. Pathology revealed the mass to be primary exophytic ESOS of the liver. The patient underwent a surgical operation and standard chemotherapy and is still alive with no recurrence and metastasis to date.

Conclusion

Owing to the rarity of the tumor and the lack of clinical characteristics and specific laboratory indexes, it is difficult to make a correct diagnosis. Medical imaging features mainly behave soft tissue entity with tumor bone composition. Surgical resection combined with adjuvant chemotherapy is the main treatment for ESOS.

Risk Factors for Development of Canine and Human Osteosarcoma: A Comparative Review

Osteosarcoma is the most common primary tumor of bone. Osteosarcomas are rare in humans, but occur more commonly in dogs. A comparative approach to studying osteosarcoma has highlighted many clinical and biologic aspects of the disease that are similar between dogs and humans; however, important species-specific differences are becoming increasingly recognized. In this review, we describe risk factors for the development of osteosarcoma in dogs and humans, including height and body size, genetics, and conditions that increase turnover of bone-forming cells, underscoring the concept that stochastic mutational events associated with cellular replication are likely to be the major molecular drivers of this disease. We also discuss adaptive, cancer-protective traits that have evolved in large, long-lived mammals, and how increasing size and longevity in the absence of natural selection can account for the elevated bone cancer risk in modern domestic dogs.

Primary Osteosarcoma of the Liver: Case Report and Literature Review

Extraskeletal osteosarcoma is a rare, highly malignant, osteoid formation mesenchymal neoplasm in the absence of bone involvement, associated with exceptionally poor prognosis. It frequently arises in the soft tissues of the extremities or in the retroperitoneum, but rarely in visceral organ. We describe a primary osteosarcoma of the liver in a 70-year-old man who presented with an episode of fever, accompanied by abdominal discomfort, after an accident abdominal strike. Ultrasonography and computed tomography revealed a large heterogeneous mass with areas of dense calcification involving most of the right lobe of liver. Radiography did not show evidence of primary tumor or primary bone lesion at any other site. Histologically, the tumor showed an essentially similar appearance as osteosarcoma originating in the skeleton, comprised of polygonal or spindle shaped cells, along with abundant eosinophilic lace-like osteoids, or irregularly arranged bone trabeculae. Immunohistochemistry showed that the tumor cells were positive for vimentin, CD10, and focally for SMA and CD56, but negative for other lineage-specific markers. Thus, the findings favored a primary hepatic osteosarcoma. This patient received palliative chemotherapy to ease the signs of his sickness due to the large size of the tumor and he died 4 moths later.