Background: Osteosarcoma (OS) is an uncommon bone cancer presented by tissue swelling and nonspecific bone pain. In case of distant metastasis, this malignancy commonly invades the lungs. Skip metastasis is an uncommon type of invasion originating from the malignant bone to adjoining bone tissues detected by magnetic resonance imaging (MRI) with high accuracy. Skip metastasis is an uncommon finding in plain radiography of osteosarcoma cases.
Case presentation: In the current study, we have reported a case of juvenile osteosarcoma with multi-focal skip metastasis, detected by simple plain radiography at first assessments. Further imaging and pathology assessment confirmed skip lesions in the background of high-grade chondroblastic osteosarcoma. Despite the recommendations, the patient and his legal guardian did not consent for further follow up and treatment.
Discussion and conclusion: Skip metastases are rarely diagnosed by plain radiography in OS cases. This condition is usually diagnosed by magnetic resonance imaging. Here, we reported a neglected and late-diagnosed case of osteosarcoma with skip lesions in a young boy, simply detected by X-ray. The following article concentrates on the importance of detecting these metastases for their correlation with patient’s survival, and describes different imaging modalities for finding them.