{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T01:03:08Z","timestamp":1774314188055,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,4,5]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>Osteosarcoma is the most common paediatric and adolescent primary bone malignancy and is highly chemosensitive. Gastrointestinal metastases from osteosarcomas are rare. Bowel perforation secondary to chemotherapy is a potential serious complication reported in ovarian, colorectal and haematological malignancies. We report the first documented case of chemotherapy-mediated bowel perforation in an osteosarcoma patient with gastrointestinal metastases. A man in his 20s, with a history of resected osteosarcoma in remission, presented with abdominal pain. A computed tomography (CT) scan demonstrated a large calcified intrabdominal mass (15\u00d713\u00d79\u2009cm) consistent with new peritoneal disease. After one cycle of palliative ifosfamide and etoposide chemotherapy, he developed a large bowel perforation and neutropenic sepsis consequently requiring resection of the perforated mass. Chemotherapy-induced bowel perforation is a rare but serious complication that should be considered in patients with osteosarcoma, and other chemosensitive malignancies, with intra-abdominal metastases. Recommencement of systemic therapies after bowel complications must be assessed cautiously on a case-by-case basis.<\/jats:p>","DOI":"10.1136\/bcr-2021-247774","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:55:16Z","timestamp":1653306916000},"page":"e247774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Metastatic osteosarcoma bowel perforation secondary to chemotherapy-induced tumour necrosis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7554-6329","authenticated-orcid":false,"given":"Megha","family":"Bhadbhade","sequence":"first","affiliation":[{"name":"Faculty of Medicine, UNSW, Sydney, New South Wales, Australia"},{"name":"Department of Surgery, Bankstown Hospital, Bankstown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5579-3728","authenticated-orcid":false,"given":"Elizabeth","family":"Connolly","sequence":"additional","affiliation":[{"name":"Sarcoma Unit, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarit","family":"Badiani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, UNSW, Sydney, New South Wales, Australia"},{"name":"Department of Surgery, Bankstown Hospital, Bankstown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Yeo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"},{"name":"Royal Prince Alfred Hospital, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Bhadri","sequence":"additional","affiliation":[{"name":"Sarcoma Unit, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,4,26]]},"reference":[{"key":"2025082803205297000_15.4.e247774.1","doi-asserted-by":"crossref","first-page":"vii320","DOI":"10.1093\/annonc\/mdq276","article-title":"Osteosarcoma","volume":"21 Suppl 7","author":"Ritter","year":"2010","journal-title":"Ann Oncol"},{"key":"2025082803205297000_15.4.e247774.2","unstructured":"Wang L , Gebhardt M , Rainusso N . 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