Online Images in the Medical Sciences| Volume 364, ISSUE 1, e17-e19, July 2022

Osteosarcoma presenting with rapidly progressive pleural calcifications

Published:February 19, 2022DOI:
      A 71-year-old man presented to the hospital with chest pain and dyspnea worsening over the past few months. His medical and surgical history included end-stage renal disease with deceased donor kidney transplant five years ago, well-controlled human immunodeficiency virus infection, and hepatitis C virus infection complicated by hepatocellular carcinoma (HCC) which was treated with surgical resection two years ago. Imaging revealed a large, loculated right pleural effusion, a calcified right mediastinal mass, multiple liver lesions, and lytic bony lesions of ribs, spine, and pelvis. Biopsy of a liver lesion revealed well-differentiated HCC. Endobronchial ultrasound-guided biopsy of the calcified mediastinal mass was nondiagnostic. Thoracentesis of the right pleural effusion revealed an exudative effusion with no malignant cells observed on cytology after multiple samples. An indwelling pleural catheter was placed, and the patient was discharged with plans for outpatient therapy for metastatic HCC.
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