SCINTIGRAPHICALLY NEGATIVE SKIP METASTASIS IN OSTEOSARCOMA

The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, as it determines the level of bone resectio n, Radiographs, isotope: bent: and MR imaging scans have been consider ed as reliable in detecting skeletal metastasis and skip lesions. We r eport a case of osteosarcoma of the distal femur with a large skip les ion proximally which was not visualized by either routine radiography or bone scintigraphy, and was not included within the scan field on th e: initial MR imaging scan. The implications on patient management and possible reasons for failure of imaging to reveal the skip metastasis are discussed.