Late Relapse of an Osteosarcoma Presenting as a Gastric Mass

Metastasis of osteosarcoma to the gastrointestinal tract is very rare. However, since the introduction of intensive adjuvant chemotherapy, the number of reported cases of gastrointestinal metastasis has been increasing in patients with osteosarcoma. Only three cases of gastric metastasis have been reported to date, and no case has been reported in Korea. Delayed metastasis long after successful treatment can also occur in osteosarcoma, particularly in patients who receive adjuvant chemotherapy and radical surgery. Hence, the possibility of gastrointestinal metastasis needs to be considered in the differential diagnosis when patients with osteosarcoma present with gastrointestinal symptoms, such as melena or hematochezia, long after successful treatment, including chemotherapy. Here, we report a recurrent osteosarcoma presenting as gastric metastasis in a patient who underwent a radical limb salvage operation followed by adjuvant chemotherapy and who had no evidence of recurrent disease for 11 years. (Korean J Med 2012;83:83-86)