Diffuse pleural metastases of osteosarcoma detected by bone scan

Osteosarcoma (OS) is a fast-growing tumor, with a high risk of local recurrence and distant metastases, with the lung and bone being the most common sites of dissemination occurring in approximately 80% of cases. Pleural metastases rarely occurs and the appearance of diffuse pleural thickening with ossification is not usual, with few such cases reported due to the current state-of-art treatment protocols. A 29-year-old woman, diagnosed with a proximal left tibial OS underwent planar and single-photon emission computed tomography/computed tomography bone scan scintigraphy with (99m)technetium methylene diphosphonate showing bilateral pleural uptake, corresponding to multiple calcified foci of thickening and nodules.