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“Introduction Osteosarcoma (OS) is the most common malignant bone tumor in adolescents and young adults, and is characterized by proliferation of tumor cells which produce osteoid or immature bone matrix. Despite recent advances in multimodality treatment consisting of aggressive adjuvant chemotherapy and wide local excision, pulmonary metastasis occurs in approximately 40 to 50% of patients with OS and remains a major cause of fatal outcome [1–3].