Lung metastasis 21 years after initial diagnosis of osteosarcoma: a case report.

INTRODUCTION: To the best of our knowledge, this case report describes the longest disease-free interval between primary diagnosis and metastatic recurrence of an osteosarcoma. CASE PRESENTATION: A 35-year-old Caucasian American man presented with asymptomatic lung metastases 21 years after being diagnosed and treated for lower extremity osteosarcoma. He underwent curative lung resection, but 2 years thereafter developed metastatic disease in the scapula and tibia and, after resection and chemotherapy, is in remission 1 year later. CONCLUSION: This case highlights the importance of long follow-up periods and continued surveillance of osteosarcoma patients after initial curative treatment.