Osteosarcoma presenting with malignant pleural effusion
The present case has been reported in the journal Respiratory Medicine Case Reports.

A 55 year old woman presented with persistent shortness of breath and right lower limb weakness. CT of the chest revealed a right pleural effusion with thickened, focally calcified irregular pleura on the right side and a calcified nodule in the left lung.

CT of the abdomen revealed a large expansile destructive lytic lesion involving the right iliac bone with a significant soft tissue component. Areas of matrix calcifications were seen within with the Codman triangle, measuring 13 × 11 × 8 cm with aggressive lamellated and sunburst type periosteal reaction.

A right lateral thoracotomy was performed and the pleural effusion was drained. The pleural mass was biopsied. Microscopic examination was highly suggestive of high grade osteosarcoma and in the presence of radiological evidence of osteosarcoma in the right ileum, the diagnosis of metastatic osteosarcoma was made.

Key words:-
- In patients with undiagnosed pleural effusion and radiological suspicion of osteosarcoma, thoracoscopy is recommended to identify and biopsy pleural metastases for establishing the definitive diagnosis.

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