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Flare Phenomenon in Osteosarcoma after Complete Remission

Departments of Diagnostic Radiology, Pathology and Pediatrics, University Hospital, Lund, Sweden

Correspondence: For correspondence or reprints contact: Kristian Herrlin, MD, Department of Diagnostic Radiology, University Hospital, S-221 85 Lund, Sweden.

ABSTRACT

A patient undergoing cytostatic therapy for osteosarcoma of the right humerus had bone scans at 2-mo intervals. A skeletal focus of increased radiotracer accumulation occurred and subsequently was confirmed by CT and MRI. A necrotic metastasis was found during biopsy. There were no remaining viable tumor cells. This finding confirms the presence of the flare phenomenon in skeletal metastases in primary malignant bone tumors and that radionuclide imaging may fail to detect intramedullary foci of viable metastases in these tumors.

Key Words: osteosarcoma • flare phenomenon • computed tomography • magnetic resonance imaging • remission