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International Orthopaedics Dec 2006Osteosarcoma, the most common type of primary malignant tumour that develops in bone, can be classified into several different sub-types. While the majority of... (Review)
Review
Osteosarcoma, the most common type of primary malignant tumour that develops in bone, can be classified into several different sub-types. While the majority of osteosarcomas are highly malignant, there are some low-grade variants. Since the introduction of chemotherapy into the multi-modal treatment regimen of high-grade osteosarcoma, its prognosis has impressively improved, with long-term survival being achieved in two-thirds of all patients. This review summarises current chemotherapeutic treatment strategies in classical osteosarcoma and also addresses the indication for chemotherapy in more unusual types and variants. It emphasises the need for treatment in specialised centres and within prospective, multi-institutional trials, amongst which EURAMOS1 and EURO-B.O.S.S are currently active in many European countries.
Topics: Antineoplastic Combined Chemotherapy Protocols; Bone Neoplasms; Humans; Osteosarcoma; Prognosis
PubMed: 16896870
DOI: 10.1007/s00264-006-0192-x -
World Neurosurgery May 2016Osteosarcoma is the second most common primary tumor of the skeletal system and the most common primary bone tumor. Usually occurring at the metaphysis of long bones,... (Review)
Review
BACKGROUND
Osteosarcoma is the second most common primary tumor of the skeletal system and the most common primary bone tumor. Usually occurring at the metaphysis of long bones, osteosarcomas are highly aggressive lesions that comprise osteoid-producing spindle cells. Craniofacial osteosarcomas comprise <8% and are believed to be less aggressive and lower grade. Primary osteosarcomas of the skull and skull base comprise <2% of all skull tumors. Osteosarcomas originating from the clivus are rare. We present a case of a primar, high-grade clival osteosarcoma.
CASE DESCRIPTION
A 29-year-old man presented to our institution with a progressively worsening right frontal headache for 3 weeks. There were no sensory or cranial nerve deficits. Computed tomography revealed a destructive mass involving the clivus with extension into the left sphenoid sinus. Magnetic resonance imaging revealed a homogenously enhancing lesion measuring 2.7 × 2.5 × 3.2 cm. The patient underwent endonasal transphenoidal surgery for gross total resection. The histopathologic analysis revealed proliferation of malignant-appearing spindled and epithelioid cells with associated osteoclast-like giant cells and a small area of osteoid production. The analysis was consistent with high-grade osteosarcoma. The patient did well and was discharged on postoperative day 2. He was referred for adjuvant radiation therapy and chemotherapy. Two-year follow-up showed postoperative changes and clival expansion caused by packing material.
CONCLUSIONS
Osteosarcoma is a highly malignant neoplasm. These lesions are usually found in the extremities; however, they may rarely present in the craniofacial region. Clival osteosarcomas are relatively infrequent. We present a case of a primary clival osteosarcoma with high-grade pathology.
Topics: Adult; Cranial Fossa, Posterior; Humans; Magnetic Resonance Imaging; Male; Neurosurgical Procedures; Nose; Osteosarcoma; Skull Base Neoplasms; Tomography Scanners, X-Ray Computed
PubMed: 26836700
DOI: 10.1016/j.wneu.2016.01.054 -
Pathobiology : Journal of... 2020Non-epithelial primary mammary osteosarcomas are extremely rare. The differentials include metaplastic carcinoma and malignant phyllodes tumour. This is the first...
INTRODUCTION
Non-epithelial primary mammary osteosarcomas are extremely rare. The differentials include metaplastic carcinoma and malignant phyllodes tumour. This is the first published case of primary breast osteosarcoma arising after local radiotherapy.
CASE PRESENTATION
A 73-year-old female presented with a right-sided breast lump. The same breast had been irradiated 11 years previously for invasive ductal carcinoma. Diagnostic excision revealed a highly cellular, malignant spindle-cell lesion merged with an osteoid matrix and foci of calcification and bone formation. Immunohistochemistry and molecular studies showed no lines of differentiation. Due to the lack of epithelial/glandular differentiation, in situ carcinoma or leaf-like pattern, the diagnosis of post-irradiation osteosarcoma was made. She underwent mastectomy and is disease-free at 8 months of follow-up.
CONCLUSION
Post-irradiation osteosarcoma should be considered in the differential diagnosis of breast lesions showing malignant osteoid. Extensive sampling and careful search for epithelial differentiation is required to guide management. Complete surgical excision is recommended.
Topics: Aged; Breast; Breast Neoplasms; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Mastectomy; Osteosarcoma; Radiation Injuries; Radiotherapy
PubMed: 32920553
DOI: 10.1159/000509580 -
Clinical Cancer Research : An Official... Feb 2022While metastatic osteosarcoma is rare in humans, it is the most common bone tumor found in any breed of dog. Given the genetic similarities between canine and human...
While metastatic osteosarcoma is rare in humans, it is the most common bone tumor found in any breed of dog. Given the genetic similarities between canine and human osteosarcomas, canine clinical trials allow for rapid testing and drug repurposing at a speed that cannot be achieved using patients with osteosarcoma. See related article by Regan et al., p. 662.
Topics: Animals; Bone Neoplasms; Dog Diseases; Dogs; Drug Repositioning; Humans; Osteosarcoma
PubMed: 34880110
DOI: 10.1158/1078-0432.CCR-21-3471 -
International Journal of Oral and... May 2023Osteosarcoma is the most common bone sarcoma and is typically found in the distal femur, proximal tibia, and proximal humerus. While several factors are known to...
Osteosarcoma is the most common bone sarcoma and is typically found in the distal femur, proximal tibia, and proximal humerus. While several factors are known to influence survival, less is known regarding the influence of primary tumor location. This study describes the clinical features and prognosis of mandibular osteosarcoma. The SEER database was utilized to identify cases of mandibular osteosarcoma diagnosed between 2004 and 2015. Sex, age, grade, histological subtype, tumor size, tumor extension, presence of metastasis at diagnosis, and therapeutic intervention were determined. Osteosarcomas originating from other sites were assessed for comparison. There were 164 cases of mandibular osteosarcoma identified, representing 5.5% of all surveyed osteosarcomas. The 2-, 5-, and 10-year overall survival rates were 79.9%, 65.6% and 58.5%, respectively. Survival was worse for patients with older age, larger tumor size, metastatic disease, and absence of surgical resection. Compared to other sites, mandibular osteosarcomas were significantly smaller tumors and were far less likely to metastasize. Mandibular osteosarcoma manifested at an older age than the more common extremity osteosarcomas and presented with smaller tumors. Rates of metastasis of jaw osteosarcoma were much lower than osteosarcoma found in the extremities, while mortality rates were comparable.
Topics: Humans; Prognosis; Bone Neoplasms; Osteosarcoma; Humerus; Tibia
PubMed: 36243646
DOI: 10.1016/j.ijom.2022.10.005 -
World Journal of Surgical Oncology Nov 2012In the head and neck region, osteosarcoma is the most common primary malignant bone tumor, representing 23% of total head and neck malignancies. Osteosarcomas of the... (Review)
Review
BACKGROUND
In the head and neck region, osteosarcoma is the most common primary malignant bone tumor, representing 23% of total head and neck malignancies. Osteosarcomas of the jaws are nevertheless rare lesions, representing only 2 to 10% of all osteosarcomas. This report reviews a single-center histopathology experience with craniofacial osteosarcomas, and reports the management of unusually large synchronous mandibular and maxillary osteosarcomas in a patient.
PATIENTS AND METHODS
A search of the hospital pathology database for specimens with a histological diagnosis of osteosarcomas submitted between July 1992 and May 2011 was made. A chart review of a patient with large synchronous maxillary and mandibular osteosarcomas was performed, and is reported.
CASE PRESENTATION
A 21-year-old African man with large maxillary and mandibular tumors under palliative care presented with increasing difficulties with eating, speech, and breathing. Surgical debulking was performed, with histology confirming synchronous osteosarcomas of the mandible and maxilla. The patient is well after one year, with no evidence of recurrence, having undergone no further treatment.
CONCLUSION
Osteosarcomas of the jaw remain enigmatic, and a number of difficulties related to their diagnosis and treatment are yet to be resolved. True synchronous multicentric osteosarcomas of the jaws are extremely rare but, like other osteosarcomas of the jaws, have a favorable outcome, and palliative resection of such lesions, though challenging, can therefore lead to an enormously improved quality of life and self-image, and may even offer the opportunity for cure.
Topics: Adult; Humans; Jaw Neoplasms; Male; Neoplasms, Multiple Primary; Osteosarcoma; Radiography
PubMed: 23140538
DOI: 10.1186/1477-7819-10-240 -
Journal of Oral and Maxillofacial... Jun 2011Periosteal osteosarcoma is an intermediate-grade chondroblastic osteosarcoma, accounting for less than 2% of all osteosarcomas and it occurs extremely rarely in the... (Review)
Review
PURPOSE
Periosteal osteosarcoma is an intermediate-grade chondroblastic osteosarcoma, accounting for less than 2% of all osteosarcomas and it occurs extremely rarely in the jaws. We present a rare case of mandibular periosteal osteosarcoma.
PATIENTS AND METHODS
A 39-year-old man presented with a four months history of a firm swelling of the mental region. The clinical, radiologic, and histologic findings pointed to a diagnosis of periosteal osteosarcoma.
RESULTS
The patient underwent a partial mandibulectomy. After ten months the lesion recurred locally. We removed the tumor together with the residual right mandible, and the patient remained without evidences of local recurrence after 22 months.
CONCLUSIONS
Periosteal osteosarcoma may give rise to local recurrence and distant metatasis. It is important to differentiate the periosteal osteosarcoma from other types. Accurate diagnosis requires correlation of clinical, radiographic, and histologic features, and wide surgical margins are mandatory for successful therapy.
Topics: Adult; Humans; Male; Mandibular Neoplasms; Osteosarcoma; Tomography, X-Ray Computed
PubMed: 21272969
DOI: 10.1016/j.joms.2010.07.066 -
The Journal of Bone and Joint Surgery.... Mar 2012There are eight reported cases in the literature of osteosarcomas secreting β-hCG. Our primary aim was to investigate the rate of β-hCG expression in osteosarcoma and... (Review)
Review
There are eight reported cases in the literature of osteosarcomas secreting β-hCG. Our primary aim was to investigate the rate of β-hCG expression in osteosarcoma and attempt to understand the characteristics of osteosarcomas that secrete β-hCG. We reviewed 37 histopathology slides (14 biopsies and 23 surgical specimens) from 32 patients with osteosarcoma. The slides were retrospectively stained for β-hCG expression. Patient and tumour characteristics, including age, gender, tumour location, subtype, proportion of necrosis, presence of metastases and recurrence were recorded. A total of five of the 32 tumours were found to be positive for β-hCG expression (one strongly and four weakly). This incidence of this expression was found in tumours with poor histological response to neoadjuvant chemotherapy. The use of β-hCG expression as a diagnostic, prognostic or follow-up marker is questionable and needs further investigation with a larger sample size.
Topics: Adolescent; Biomarkers, Tumor; Biopsy; Bone Neoplasms; Chemotherapy, Adjuvant; Child; Chorionic Gonadotropin, beta Subunit, Human; Female; Humans; Magnetic Resonance Imaging; Male; Neoadjuvant Therapy; Neoplasm Proteins; Neoplasm Recurrence, Local; Osteosarcoma; Prognosis; Retrospective Studies; Young Adult
PubMed: 22371553
DOI: 10.1302/0301-620X.94B3.27679 -
Journal of Orthopaedic Science :... 1998The definition of osteosarcoma requires that a malignant tumor of bone produce osteoid or bony matrix. With this as a basic definition, osteosarcoma of bone can be...
The definition of osteosarcoma requires that a malignant tumor of bone produce osteoid or bony matrix. With this as a basic definition, osteosarcoma of bone can be divided into several clinicopathologic entities based on clinical, roentgenographic, and pathologic features. The tumors can be broadly divided into those arising within the bone and those arising on the surface of bone. Most intraosseous osteosarcomas are high-grade malignant tumors that occur in children and adolescents. A small number occur in older patients, and they may be related to a preexisting condition, such as Paget's disease or radiation. The site of the lesion has prognostic importance. Osteosarcoma of the jaws is associated with an especially good prognosis, whereas the same kind of tumor involving the skull has a very poor prognosis. Most osteosarcomas of the surface of bone are well or moderately differentiated and are associated with an excellent prognosis.
Topics: Bone Neoplasms; Humans; Osteosarcoma; Radiography
PubMed: 9732564
DOI: 10.1007/s007760050055 -
Cancer Nov 1979Multifocal osteosarcoma with unique patho-biological features in a 23-year old white male is reported. The natural history and classification of multiple osteosarcomas... (Review)
Review
Multifocal osteosarcoma with unique patho-biological features in a 23-year old white male is reported. The natural history and classification of multiple osteosarcomas are reviewed. A proposal is presented for evaluation of the multicentric origin in future cases.
Topics: Adolescent; Adult; Age Factors; Bone Neoplasms; Child; Female; Humans; Male; Middle Aged; Neoplasms, Multiple Primary; Osteosarcoma
PubMed: 387210
DOI: 10.1002/1097-0142(197911)44:5<1897::aid-cncr2820440552>3.0.co;2-2