SIMULTANEOUS OCCURRENCE OF LUNG ADENOCARCINOMA AND FIBULAR OSTEOSARCOMA IN A 13-YEAR-OLD GIRL

Bronchogenic cancer in the pediatric age group is extremely rare and l ess than 100 cases have been reported in the world literature. We repo rt a 13-year-old girl with simultaneous occurrence of lung adenocarcin oma and osteosarcoma. The patient was admitted with lower leg pain, an d an abnormal shadow in the right fibula was noted on X-ray examinatio n. Further examination of the fibular lesion including tumor biopsy re vealed an osteosarcoma. Following completion of the first course of pr eoperative chemotherapy, multiple lung shadows were found on chest X-r ay films. After five courses of preoperative chemotherapy, however, al l lung shadows except one in the right lower lobe disappeared. The fib ular tumor was then resected. Postoperatively, an additional six cours es of chemotherapy was given. However, the lung shadow in the right lo wer lobe was still present. Exploratory thoracotomy was performed. Pat hologically, the lung tumor measured 0.8 cm in diameter with an ill-de fined border, and histological examination revealed a well differentia ted papillary adenocarcinoma. To our knowledge, only a few cases of pe diatric lung cancers have been reported to be associated with congenit al cystic malformation of the lung. However, this combination of pedia tric lung adenocarcinoma and osteosarcoma has not been previously repo rted.