Pulmonary toxocariasis masquerading as metastatic tumor nodules in a child with osteosarcoma

Pediatr Blood Cancer. 2009 Dec 15;53(7):1343-5. doi: 10.1002/pbc.22213.

Abstract

A 14-year-old male, who completed chemotherapy following limb salvage surgery for osteosarcoma approximately 2 years ago, was seen for routine follow-up. A CT scan revealed new scattered multifocal nodular lesions. An ultrasonography-guided percutaneous needle biopsy was done to confirm pulmonary metastasis of the underlying osteosarcoma. The lung biopsy showed findings of eosinophilic pneumonia with no evidence of malignancy. Peripheral eosinophilia was also noted. When a more thorough history revealed frequent intake of raw cow liver, we diagnosed pulmonary toxocariasis by ELISA for specific serum IgG antibody.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Antibodies, Helminth / blood
  • Antineoplastic Combined Chemotherapy Protocols
  • Bone Neoplasms / drug therapy
  • Bone Neoplasms / surgery
  • Cattle / parasitology
  • Cattle Diseases / parasitology
  • Cisplatin / administration & dosage
  • Diagnosis, Differential
  • Doxorubicin / administration & dosage
  • Food Parasitology
  • Humans
  • Humerus
  • Immunoglobulin G / blood
  • Larva Migrans, Visceral / diagnosis*
  • Larva Migrans, Visceral / transmission
  • Liver / parasitology
  • Lung Diseases, Parasitic / diagnosis*
  • Lung Diseases, Parasitic / transmission
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / secondary
  • Male
  • Meat / adverse effects
  • Meat / parasitology
  • Methotrexate / administration & dosage
  • Osteosarcoma / diagnosis*
  • Osteosarcoma / drug therapy
  • Osteosarcoma / secondary
  • Osteosarcoma / surgery
  • Pulmonary Eosinophilia / diagnosis*
  • Pulmonary Eosinophilia / etiology
  • Toxocariasis / transmission

Substances

  • Antibodies, Helminth
  • Immunoglobulin G
  • Doxorubicin
  • Cisplatin
  • Methotrexate