Sir,. Multifocal osteosarcoma is described as occurrence of tumor at two or more sites in a patient without pulmonary metastases.1 It may be synchronous (more ...
Letter to the Editor dizygotic twins. Pediatr Surg Int 1998; 13: 88-90. 5. Becker J, Hernandez A, Dipietro M, Coran AG. Identical twins concordant for pulmonary sequestration communicating with the esophagus and discordant for the VACTERL association. Pediatr Surg Int 2005; 21: 541-546. 6. Nakayama D, Masuzaki H, Yoshimura S, Moriyama S,
Ishimaru T. Monozygotic twins discordant for single umbilical artery and congenital heart disease. Am J Obstet Gynecol 1998; 179: 256-257. 7. Tang Y, Chang-Xing Ma, Wei Cui et al. The Risk of Birth Defects in Multiple Births: A Population-Based Study. 2006; 10 : 75-81.
Metastatic or Metachronous Osteosarcoma: A Clinical Dilemma Sir, Multifocal osteosarcoma is described as occurrence of tumor at two or more sites in a patient without pulmonary metastases.1 It may be synchronous (more than one lesion at presentation) or metachronous (new tumors developing after initial treatment).2 A 14-year-old male presented with a 15x10 cm swelling of left lower femur of six months duration. Hemogram and biochemistry including serum alkaline phosphatase were normal; serum lactate dehydrogenase was 954 IU/L (Normal
