PMC2694310_01
Plain radiography at first visit. Marked calcification was observed in the right thigh.
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Plain radiography of the right thigh showed a large soft tissue mass with marked calcification in a radial pattern (Figure 1).
Computed tomography of thigh. The tumor was not in contact with the femur or its periosteum.
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Computed tomography (CT) showed that many refined calcifications were scattered in the mass, and it was not in contact with the femur or pelvis (Figure 2).
Magnetic resonance imaging of the tumor. (a) T1-weighed MRI. The mass showed mixed low and iso-intensity signals. (b) T2-weighed MRI. The mass showed mixed high and iso-intensity signals. (c) The tumor was enhanced remarkably by gadolinium.
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After intravenous administration of a gadolinium-based contrast material, the tumor was well enhanced (Figure 3).
Gallium scintigraphy showed increased uptake in the primary tumor only.
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Gallium scintigraphy showed marked heterogeneous accumulation especially in distal part of tumor (Figure 4).
Plain radiography of lung. Multiple metastatic lesions in both lungs were found at first visit.
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Plain chest radiography revealed 8 nodular densities in the left lung and 6 in the right, which were considered to be metastasis (Figure 5).
Plain radiography of lung at the final follow-up. Secondary lesion in left lung grew remarkably, and mediastinum was pressured severely.
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Nevertheless, the pulmonary lesion maintained its momentum conclusively occupying the left lung (Figure 6) and causing breathing difficulties.
Histological section. (a) tumor of the thigh. Formation of osteoid was observed (x200). (b) strong magnification of Figure 7(a). (x400) (c) metastatic lesion (x200).
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The other pulmonary metastasis sites did not have any osteoid material (Figure 7).