• Medicine · Aug 2021

    Case Reports

    Long-term survival following radiofrequency ablation of lung metastases in an elderly patient with calcaneal osteosarcoma: A case report and review of the literature.

    • Hiroyuki Futani, Haruyuki Takaki, Tatsuo Sawai, Junichi Taniguchi, Yasukazu Kako, Yoshi-Hiro Ide, Koichiro Yamakado, and Toshiya Tachibana.
    • Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan.
    • Medicine (Baltimore). 2021 Aug 27; 100 (34): e26681e26681.

    RationaleRecently, the number of osteosarcomas has been increasing in elderly patients due to human longevity. Lung metastases are the primary cause of death from osteosarcomas. Complete resection of lung metastases can prolong the survival. However, complete resection in elderly patients is often difficult due to high risk of operative complications. Computed tomography (CT) guided radiofrequency ablation (RFA) is a minimally invasive technique to destroy tumor nodules using heat. In this report, we present the first case older than 65 years applying RFA for lung metastases due to osteosarcoma.Patient ConcernsA 74-year-old male presented with 1-year history of heel pain. A conventional high-grade osteosarcoma in his calcaneus was diagnosed. Below-knee amputation was performed. However, lung metastases were found in both lungs 1 year after amputation. CT-guided lung RFA was chosen since surgical intervention for lung metastases was abandoned because of tumor multiplicity and medical comorbidities. A total of 18 lung metastases were treated by CT-guided RFA. The most frequent complication was pneumothoraxes in 4 of 8 (50%) procedures and chest tube drainage was required in 2 of these (2 of 8 (25%) procedures).DiagnosesSix lung metastases of osteosaroma were found in both lungs at 1 year after surgery.InterventionsCT-guided lung RFA was performed. A total of 18 lung metastases were treated in 8 lung RF procedures.OutcomesThe patient has been alive with disease for 5.5 years after the initial surgery.LessonsCT-guided lung RFA is effective for elderly patients with osteosarcoma lung metastases in spite of discouragement of lung metastasectomy due to multiplicity of metastases and medical-comorbidities.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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