Extraskeletal osteosarcoma of the pleura:report of a case

Our plain-English summary of Extraskeletal osteosarcoma of the pleura:report of a case, by H. Shiota, T. Yasukawa, A. Hirai, et al (Annals of Thoracic and Cardiovascular Surgery, 2013).

The study

• Authors: H. Shiota, T. Yasukawa, A. Hirai, M. Chiyo, T. Yusa, K. Hiroshima
• Journal: Annals of Thoracic and Cardiovascular Surgery
• Published: 2013;19(4):297-301
• Type of article: Case report
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Extraskeletal osteosarcoma is a rare malignant tumor occurring very rarely in the pleura. We herein report the case of 67-year-old man with asbestos exposure, who underwent biopsies of the large tumor from the chest wall, and diagnosed as a suspicious of fibrosarcoma. Surgical resection was done, and the pathological diagnosis was extraskeletal osteosarcoma arising from the pleura. The differential diagnosis is malignant pleural mesothelioma with osseous and cartilaginous which is also very rare and one of the histopathological subtypes with heterologous elements. Identification of epithelial components, labeling for cytokeratins in spindle cells and its' anatomical distribution may help to distinguish them. In the neoplasm arising from the parietal pleura, primary extraskeletal osteosarcoma of the pleura is very rare, but should be considered.

In plain English

This article was a case report about one patient from Japan. A 67-year-old man had worked in the construction of electric power substations from age 28 to 60 and had a history of asbestos exposure. He had also smoked 15 cigarettes a day for 46 years. In October 2008 a CT scan showed calcification in the lining of his right chest wall, which was followed up as calcified pleural plaques. In 2009 he developed breathlessness and a large fluid build-up in the right chest. A biopsy suggested fibrosarcoma. The mass, 12 × 10 × 8 cm, was removed together with two ribs. The final diagnosis was osteosarcoma (a bone-forming cancer) arising from the pleura, not from bone. The authors found no features supporting malignant mesothelioma. Despite chemotherapy the tumor came back, and he died of respiratory failure about two years after surgery. The authors counted eight reported cases of this tumor in the pleura, including this one, with asbestos exposure noted in this case and one other. The authors concluded that this tumor is very rare but should be considered when pleural calcifications are found.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report
• Who was studied: One 67-year-old man, first examined in October 2008 and referred to Chiba Rosai Hospital, Japan, in April 2009
• Exposure: Occupational asbestos exposure from working in the construction of electric power substations from age 28 to 60. The fiber type was not stated. He also smoked 15 cigarettes a day for 46 years.
• Main results:
  • Calcification in the right parietal pleura was first followed up as calcified pleural plaques
  • At thoracoscopy, multiple pleural plaques were seen in the parietal pleura
  • Biopsy of the mass suggested fibrosarcoma
  • The surgically removed mass measured 12 × 10 × 8 cm
  • The tumor was diagnosed as extraskeletal osteosarcoma of the pleura rather than mesothelioma: there was no epithelioid mesothelioma component, and the spindle cells were cytokeratin-negative
  • A new lesion appeared 9 months after surgery despite chemotherapy with cisplatin and adriamycin
  • The patient died of respiratory failure about 2 years after the operation
  • Among the 8 reported cases of primary extraskeletal osteosarcoma of the pleura that the authors counted, asbestos exposure was indicated in this case and one other
• The authors' conclusion: The authors concluded that primary extraskeletal osteosarcoma of the pleura is very rare but should be considered when pleural calcifications are found

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Asbestos Exposure, Surgical Resection, Differential Diagnosis, Pleural Mesothelioma, Heterologous Elements, Spindle Cell, Neoplasm.

Related studies

• Osteosarcoma pleural effusion: A diagnostic challenge with some cytologic hints — B. AbdullGaffar (2021)
• Extraskeletal myxoid chondrosarcoma of the pleura. Report of a case clinically simulating mesothelioma — S.P. Goetz, R.A. Robinson, et al. (1992)
• Heterologous sarcomatoid pleural mesothelioma with osteosarcomatous differentiation: a report of autopsy case that accomplished trimodality therapy and review of the literature — H. Itano, T. Takeda, et al. (2020)
• A left pleural effusion with a calcified tumoral mass and left hemithoracic uptake on bone scan — E. Quoix, M.P. Chenard, et al. (2001)
• Huge malignant solitary fibrous tumor of the pleura — W.A. Arab, D. Lamoth, et al. (2012)
• The differential diagnosis between pleural sarcomatoid mesothelioma and spindle cell/pleomorphic (sarcomatoid) carcinomas of the lung: evidence-based guidelines from the International Mesothelioma Panel and the MESOPATH National Reference Center — A.M. Marchevsky, N. LeStang, et al. (2017)

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