Multifocal osteosarcoma: An unusual presentation

Purpose: Report the unusual presentation, clinical course, and cytogenetic abnormalities in a child with multifocal osteosarcoma. Patients and Methods: A 10-year-old boy had multifocal osteosarcoma involvi ng the entire skeleton, pleural bone marrow, and lungs. He had marked anemi a, thrombocytopenia, and severe hypocalcemia at diagnosis. Results: Despite aggressive chemotherapy, he died from progressive disease 1 month after diagnosis. Cytogenetic analysis of tumor cells within the ple ural fluid showed multiple chromosomal abnormalities with amplification of the c-myc oncogene. Conclusion: Multifocal osteosarcoma should be considered in the differentia l diagnosis of a child with pancytopenia and multiple bone lesions. Amplifi cation of the c-myc oncogene may have had a significant role in the pathoge nesis, etiology, and rapid progression of this patient's multifocal disease . Additional studies will be needed to determine the biologic significance of c-myc amplification in multifocal osteosarcoma.