Unilateral pulmonary metastasis in a patient with osteogenic sarcoma surviving longer than 13 years after leg amputation.

A case of osteogenic sarcoma of the left fibula in a patient surviving longer than 13 years after amputation and developing an unusual pattern of late metastasis, including a unilateral pulmonary mass, is presented. Autopsy revealed unilateral pulmonary metastasis with extensive old, "burned-out" areas, in contrast to extrapulmonary metastatic deposits composed exclusively of fresh tumor tissue, suggesting secondary development of extrapulmonary metastases from the pulmonary lesion. In addition to the possibility of metastatic disease even after post-therapeutic survival of more than 10 years, unusual manifestation of late metastasis is discussed in the light of a review of the literature.