A 16-year-old boy had osteosarcoma of the distal left femur diagnosed at age 10. At presentation there was no evidence of bony or pulmonary metastases. Five years later, the right ring finger was amputated because of bony recurrence at that site, and soon after the patient underwent bilateral thoracotomies for resection of pulmonary metastases. Follow-up evaluation with Tc-99m MDP skeletal scintigraphy demonstrated a large region of increased uptake in the left upper quadrant of the abdomen. Noncontrast axial CT revealed a large calcified soft tissue mass in the left suprarenal region consistent with adrenal metastasis from osteosarcoma.
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