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Metal-induced sarcoma. A case report and literature review.

The overall biocompatibility characteristics of metallic implants are important considerations in orthopedic surgery. A review of the literature shows very few reports of neoplasms in association with metallic implants. This case report demonstrates osteogenic sarcoma at the site of a Smith-Petersen nail that had been implanted for nine years in a 65-year-old woman for fixation of a femoral neck fracture. Gross examination revealed debris at the tumor site, with a concentration of 14 ppm of nickel within the tumor tissue. Experimental investigations support the possibility of neoplastic induction by heavy metals, particularly cobalt, cadmium, and nickel. Circumstantial evidence shows osteogenic sarcoma that developed at the site of this device, possibly in response to metal or factors at the site of metal.