Bronchioloalveolar carcinoma as a second malignancy in osteosarcoma survivors

Second malignancies occur in 2–3% of survivors of pediatric osteosarcoma; treatment‐related hematologic and solid malignancies have both been described. We present two cases of patients with pulmonary nodules that developed more than 2 years after treatment of osteosarcoma. Both lesions were completely resected and pathology revealed bronchioloalveolar carcinoma (BAC). Primary BAC is extremely rare in children; however, cases of this malignancy have been described in survivors of pediatric cancer. BAC may present as a solitary pulmonary nodule indistinguishable from a metastatic lesion and should be included in the differential diagnosis of pulmonary nodules in survivors of pediatric cancer. Pediatr Blood Cancer 2009;53:499–501. © 2009 Wiley‐Liss, Inc.