A greenstick osteoporotic tibial fracture while on chemotherapy in a 12-year-old girl with osteosarcoma of the knee: does a preventive role exist for agents that reduce iatrogenic bone loss and skeletal-related events?

• Published in: Journal of biological regulators and homeostatic agents Vol. 25; no. 1; p. 131
• Main Authors: Zoccali, C, Chichierchia, G, Prencipe, U, Nuzzo, C, Anelli, V, Ferraresi, V
• Format: Journal Article
• Language: English
• Published: Italy 01.01.2011
• Subjects: Antimetabolites, Antineoplastic - administration & dosage; Antimetabolites, Antineoplastic - adverse effects; Bone Neoplasms - diagnostic imaging; Bone Neoplasms - drug therapy; Child; Female; Humans; Knee; Methotrexate - administration & dosage; Methotrexate - adverse effects; Osteoporosis - chemically induced; Osteoporosis - diagnostic imaging; Osteoporosis - therapy; Osteosarcoma - diagnostic imaging; Osteosarcoma - drug therapy; Radiography; Tibial Fractures - chemically induced; Tibial Fractures - diagnostic imaging; Tibial Fractures - therapy
• ISSN: 0393-974X

In patients with osteosarcoma several causative factors are implicated in the occurrence of osteoporosis, such as no weight-bearing, pre- and post-surgical immobilization, and neoadjuvant and adjuvant chemotherapy. Nevertheless, osteoporotic fractures are a rare complication in young patients. We report the case of a spontaneous greenstick fracture of the distal tibia occurring during adjuvant chemotherapy in a 12-year-old Caucasian girl. Among the various drugs, the main role of methotrexate was investigated. A review of the literature is also presented along with a discussion about the role of preventive agents able to reduce the occurrence of osteopenia and/or osteoporosis following cancer treatment.