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Medicine Dec 2017Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of... (Review)
Review
RATIONALE
Primary osteosarcomas of the skull and skull base are rare, comprising <2% of all skull tumors. Primary osteosarcomas of the skull are aggressive neoplasms composed of spindle cells producing osteoid which have poor outcome.
PATIENT CONCERNS
A 33-year-old woman was admitted to our hospital with a major complaint of a growing mass on her left frontal region of the skull for 10 months. Prior to the accurate diagnosis, the mass on her skull was considered to be eosinophilic granuloma.
DIAGNOSES
Computerized tomogram (CT) scan of skull revealed a lytic lesion causing destruction of left frontal bone with surrounding soft tissue mass. The histological examination of the lesion showed typical features of osteosarcoma.
INTERVENTIONS
The patient received 3 surgeries and adjuvant chemotherapy and radiotherapy for the frontal bone lesion.
OUTCOMES
At the last follow-up, after 4 years, the patient was free of disease both clinically and on imaging by magnetic resonance imaging (MRI) scan after 4 years.
LESSONS
Because osteosarcoma of skull is a rare disease, the early recognition and correct diagnosis are very important for a better prognosis. It is therefore imperative that clinicians recognize osteosarcoma early to make an accurate diagnosis and complete surgical resection followed by combined chemo-radiation is proved to be one of the most optimal treatment regimens.
Topics: Adult; Female; Frontal Bone; Humans; Osteosarcoma; Skull Neoplasms; Tomography, X-Ray Computed
PubMed: 29390546
DOI: 10.1097/MD.0000000000009392 -
The British Journal of Radiology Nov 1981Fifteen cases of diaphyseal osteosarcomas were found in a review of 157 cases of long bone osteosarcoma (9.5%) and two further examples were added. The clinical and...
Fifteen cases of diaphyseal osteosarcomas were found in a review of 157 cases of long bone osteosarcoma (9.5%) and two further examples were added. The clinical and histological features of the diaphyseal osteosarcomas were indistinguishable from those of the commoner juxta metaphyseal osteosarcomas. The radiological features, however, fell into four distinct patterns: Group I had the classical appearance of a conventional osteosarcoma; Group II showed dense cortical sclerosis with bony expansion but no soft tissue swelling or break of the cortex at presentation; Group III presented with a pathological fracture through a purely osteolytic lesion; Group IV usually had the classical appearances of an osteosarcoma in the diaphysis but had, in addition, dense separate sclerotic lesions which were proximal to the tumour in the humerus and distal to it in the femur. The importance of these four groups lies in the quite distinct differential diagnosis which each presents.
Topics: Adolescent; Adult; Aged; Bone Neoplasms; Bone and Bones; Child; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Osteosarcoma; Radiography; Sclerosis
PubMed: 6946854
DOI: 10.1259/0007-1285-54-647-932 -
Acta Chirurgica Belgica Aug 2021Soft-tissue osteosarcomas are very rare. Only three cases of extraskeletal osteosarcoma have been reported arising in colon and we report the first well differentiated...
BACKGROUND
Soft-tissue osteosarcomas are very rare. Only three cases of extraskeletal osteosarcoma have been reported arising in colon and we report the first well differentiated one.
PATIENTS AND METHODS
A 58-year-old woman was admitted to our hospital with a history of pain and swelling in lower right abdomen for the last 3 months. Routine laboratory tests and tumor markers (CEA, CA19-9, AFP) were all normal, as well as colonoscopy. CT-scan revealed large partly calcificated mass connected to the ascending colon without significant imbibition of contrast. Because of the size of the tumor, open surgery was indicated. An exploratory laparotomy followed by right hemicolectomy with anastomosis was performed according to oncological principles.
RESULTS
Surgery and pathology confirmed the presence of 13 cm large soft tissue tumor connected to the colon by vascular pedicle. Histopathology showed spindle cells with minimal cellular atypia and focal osteoid production which lead to diagnosis of low grade osteosarcoma. Immunohistochemicaly, neoplastic cells were positive for alpha smooth muscle actin, caldesmon and desmin, but are negative for S100, CD34, CD117, DOG1, BCL-2, epithelial membrane antigen, and beta-catenin.
CONCLUSION
Postoperative course went uneventful and adjuvant chemotherapy was not recommended. At 6-months follow-up there was no sign of recurrent tumor.
Topics: Bone Neoplasms; Colon; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Osteosarcoma; Soft Tissue Neoplasms
PubMed: 31701810
DOI: 10.1080/00015458.2019.1689647 -
Journal of Cancer Research and... 2015Laryngeal osteosarcoma is an extremely rare and aggressive malignancy. Only very few cases of primary laryngeal osteosarcomas are reported in literature, and all have a... (Review)
Review
Laryngeal osteosarcoma is an extremely rare and aggressive malignancy. Only very few cases of primary laryngeal osteosarcomas are reported in literature, and all have a dismal prognosis. A 50-year-old male presented with recurrent hoarseness of voice and was evaluated and diagnosed as sarcoma larynx. Detailed histopathology report of laryngectomy specimen revealed presence of osteoid, which confirmed the diagnosis of osteosarcoma larynx. He was further treated with adjuvant chemotherapy and radiation and is disease free after 9 months. Surgery remains the mainstay of treatment in this disease and role of adjuvant chemotherapy and radiotherapy is still evolving.
Topics: Bone Neoplasms; Chemoradiotherapy; Humans; Laryngeal Neoplasms; Male; Middle Aged; Osteosarcoma; Prognosis
PubMed: 26881648
DOI: 10.4103/0973-1482.139274 -
Cancer Nov 1987Extraskeletal osteosarcomas are infrequent, and those that arise within parenchymal organs are very rare indeed. This case of a 71-year-old man with a primary... (Review)
Review
Extraskeletal osteosarcomas are infrequent, and those that arise within parenchymal organs are very rare indeed. This case of a 71-year-old man with a primary osteosarcoma of the liver is the second reported in man. Pathologic findings, including ultrastructural features, at surgery and autopsy are presented. The differential diagnosis is discussed in detail.
Topics: Aged; Humans; Liver Neoplasms; Male; Neoplasm Recurrence, Local; Osteosarcoma
PubMed: 3326654
DOI: 10.1002/1097-0142(19871101)60:9<2312::aid-cncr2820600933>3.0.co;2-w -
Cancer Jan 1985A series of 17 patients with osteosarcomas that histologically resembled osteoblastomas was studied. The ages of the 9 male and 8 female patients ranged from 11 to 58...
A series of 17 patients with osteosarcomas that histologically resembled osteoblastomas was studied. The ages of the 9 male and 8 female patients ranged from 11 to 58 years. The roentgenographic appearance was suggestive of malignancy in most cases. Two histologic features seemed most important in differentiating osteosarcoma from osteoblastoma. In the former, there is permeation of surrounding tissues and lack of "maturation" toward the edges, whereas osteoblastoma tends to show maturation peripherally and is circumscribed. Osteoblastoma-like osteosarcoma should be considered to be a malignant tumor because 7 of the 17 patients died of their disease. The authors believe that malignant osteoblastoma and aggressive osteoblastoma are really osteosarcomas that resemble osteoblastomas.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Osteoma, Osteoid; Osteosarcoma; Tomography, X-Ray Computed
PubMed: 3855268
DOI: 10.1002/1097-0142(19850115)55:2<416::aid-cncr2820550221>3.0.co;2-5 -
Cancer Treatment and Research 2009Most data on osteosarcoma is derived from pediatric studies. Although the majority of adult patients with osteosarcoma are young adults, who might be treated in a... (Comparative Study)
Comparative Study Review
Most data on osteosarcoma is derived from pediatric studies. Although the majority of adult patients with osteosarcoma are young adults, who might be treated in a similar fashion, experience derived from a slightly older population is helpful in directing therapy. We treated a series of 123 patients with osteosarcoma of the extremities with adriamycin and cisplatin as induction therapy. Adriamycin was infused intravenously at 90 mg/m2 over 96 h. Cisplatin was infused intra-arterially at 120-160 mg/m2 over 2-24 h. Sequential addition of methotrexate and methotrexate plus ifosfamide in subsequent cohorts improved the continuous relapse-free survival of poor responders such that overall survival improvement was noted in the group where therapy was modified by adding both agents to those with <90% tumor necrosis. Patients with chondroblastic osteosarcoma with poor necrosis had a trend towards improved continuous relapse-free survival compared with other patients with conventional osteosarcoma. Histologic variants of osteosarcoma except telangiectatic osteosarcoma had a worse prognosis than those with conventional osteosarcoma. The variants, especially dedifferentiated parosteal osteosarcoma and dedifferentiated well-differentiated intraosseous osteosarcoma are more common in adults than children, accounting for some of the inferior prognosis in adults. Older patients obviously cannot tolerate the doses of therapy given to children and young adults, again decreasing the chances of successful treatment. Patients with secondary osteosarcoma are often much older as are many with osteosarcomas of the pelvis and jaw. These tumors tend to be less responsive. An attempt to intensify therapy in poor-prognosis patients with a three-drug regimen of adriamycin, cisplatin, and ifosfamide with peripheral stem cell support was unsuccessful at prolonging relapse-free survival, and we no longer use that approach.
Topics: Adult; Bone Neoplasms; Child; Humans; Osteosarcoma
PubMed: 20213401
DOI: 10.1007/978-1-4419-0284-9_19 -
Current Oncology (Toronto, Ont.) Jun 2023Osteosarcoma is a rare condition with a complex treatment. Most protocols include neoadjuvant chemotherapy, surgery, and consolidation chemotherapy as the standard of... (Review)
Review
Osteosarcoma is a rare condition with a complex treatment. Most protocols include neoadjuvant chemotherapy, surgery, and consolidation chemotherapy as the standard of treatment. However, the use of neoadjuvant chemotherapy lacks scientific evidence proving superiority in opposition to the use of isolated chemotherapy in an adjuvant regimen after surgery. We conducted a review for studies published in English between 1980 and 2020, using the MEDLINE/PubMed and Scopus electronic databases, to evaluate the outcomes when using neoadjuvant chemotherapy or adjuvant chemotherapy strategies in the treatment of non-metastatic appendicular osteosarcoma, as well as the toxicity associated with different chemotherapeutic regimens. Patients were divided into a neoadjuvant chemotherapy group (NAC) and adjuvant chemotherapy group (ACT), depending on the chemotherapy regimen used in association with surgery. A total of 1254 articles in English were screened by title and abstract, and 146 were pre-selected for full reading and analysis. A total of 24 assays matching the inclusion criteria were selected: 10 prospective and 14 retrospective studies. This review points to an absence of significative differences in outcomes, namely overall survival, disease-free survival/event-free survival rates, or toxicity, regarding neoadjuvant or single adjuvant chemotherapy strategies used in the treatment of appendicular non-metastatic osteosarcomas. However, there is a significative difference in population dimensions between the NAC and the ACT groups. Additionally, clinical presentation, tumor localization, tumor volume, or histological type were not considered, with these variables presenting the potential to influence these results. Despite these limitations, our findings should allow a re-thinking of our current practice and promote new opportunities to optimize treatment, always looking towards better survival and lower complications rates.
Topics: Humans; Retrospective Studies; Prospective Studies; Antineoplastic Combined Chemotherapy Protocols; Osteosarcoma; Bone Neoplasms
PubMed: 37504317
DOI: 10.3390/curroncol30070457 -
Histopathology Feb 2019Osteoblastoma-like osteosarcoma is a rare variant of osteosarcoma (1% of all osteosarcomas), histologically similar to osteoblastoma. In the current World Health...
AIMS
Osteoblastoma-like osteosarcoma is a rare variant of osteosarcoma (1% of all osteosarcomas), histologically similar to osteoblastoma. In the current World Health Organisation (WHO) classification, osteoblastoma-like osteosarcoma is classified within the group of conventional (high-grade) osteosarcomas. However, several published cases have been actually regarded as low-grade malignant tumours. As strict morphological criteria to distinguish between low- and high-grade lesions are not available, we reviewed our series of osteoblastoma-like osteosarcomas in the attempt to identify clinical and morphological features predictive of aggressiveness.
METHODS AND RESULTS
We retrieved 15 cases of osteoblastoma-like osteosarcoma from the files of the Istituto Ortopedico Rizzoli. Patients received various treatments. Five patients developed metastasis and five patients developed local recurrences (all after incomplete surgery). Eleven patients were alive without disease, while four patients died of their disease. Statistical analysis revealed a statistically significant (P = 0.048) lower disease-free survival in patients with areas of conventional (high-grade) osteosarcoma.
CONCLUSIONS
With the important limitation of a small cohort of patients, the presence of areas of conventional (high-grade) osteosarcoma is the only parameter to predict the aggressiveness of osteoblastoma-like osteosarcoma.
Topics: Adolescent; Adult; Bone Neoplasms; Child; Disease-Free Survival; Female; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Neoplasm Grading; Osteoblastoma; Osteosarcoma; Young Adult
PubMed: 30152881
DOI: 10.1111/his.13746 -
International Journal of Pediatric... Jan 2008Osteosarcoma is the most common primary malignancy of bone in children and adolescents. Osteosarcomas are an aggressive neoplasm composed of spindle cells producing... (Review)
Review
Osteosarcoma is the most common primary malignancy of bone in children and adolescents. Osteosarcomas are an aggressive neoplasm composed of spindle cells producing osteoid. They primarily affect the long bones, particularly after radiation or chemotherapy for other neoplasms; however, 6-7% present in the head and neck. Primary head and neck osteosarcomas in children are rare. There are few case reports and limited-sized case series in the literature. A case report presentation of a skull base osteosarcoma in a teenage female. A 14-year-old African American female presented with dysphagia, voice changes, and neck pain. On examination, she had right-sided palsies in cranial nerves X, XI, and XII. Imaging revealed partial enhancement of the clivus without bony erosion and expansion of the hypoglossal canal. There were also findings consistent with chronic denervation of her right tongue and pharynx. During the evaluation process, she developed diplopia from a right cranial nerve VI palsy. Repeat imaging revealed progression of the skull base lesion with extension into the right sphenoid sinus. An endoscopic sphenoidotomy was performed to obtain tissue. The diagnosis of high-grade osteosarcoma was made by histologic morphology and immunohistochemistry. The child was treated primarily with chemotherapy. Other adjunctive therapies are being considered. Osteosarcoma of the skull base is a rare entity. We describe a case of a high-grade clival osteosarcoma presenting primarily with lower cranial nerve palsies and pain. The rapid progression, treatment options, and prognosis are discussed.
Topics: Adolescent; Female; Humans; Osteosarcoma; Prognosis; Skull Base Neoplasms
PubMed: 17980919
DOI: 10.1016/j.ijporl.2007.08.015