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Virtual Pediatric Hospital: Paediapaedia: Metastases, Pulmonary Paediapaedia: Chest and Airway Diseases

Metastases, Pulmonary

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Much more common than primary lung tumors in children.

Etiology/Pathophysiology:
Usually due to hematogenous spread of tumor. Less common pathways of spread include the lymphatics, bronchi, pleura, and direct invasion. Common causes include Wilms tumor, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, fibrosarcoma, lymphoma, and testicular and ovarian germ cell tumors. Osteosarcoma and Wilms are the most common.

Pathology:
Not applicable

Imaging Findings:
Single or multiple soft tissue nodules of variable size in the lung which are most commonly peripheral and sub pleural in location. Metastases from sarcomas can cause pneumothoraces. Osteosarcoma metastases can calcify. CT is far more sensitive for detection than the CXR.

DDX:

References:

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