-
Sarcoma 2022Parosteal osteosarcoma (PAOS) is a surface osteosarcoma. Treatment options include wide excision and endoprosthetic or allograft. However, due to the low local...
BACKGROUND
Parosteal osteosarcoma (PAOS) is a surface osteosarcoma. Treatment options include wide excision and endoprosthetic or allograft. However, due to the low local recurrence and metastasis rate, when it appears in the posterior surface of the distal femur, the lesion can be managed with hemicortical wide resection and biological reconstruction with hemicortical allograft. The purpose of this study is to evaluate the oncological and functional outcomes of patients with parosteal osteosarcoma (PAOS) of the posterior cortex of the distal femur who underwent biological reconstruction after hemicortical resection.
METHODS
Eleven patients who underwent wide tumor resection and defect reconstruction of the posterior surface of the distal femur using hemicortical allograft were retrospectively studied. Local recurrence, metastasis, complications, and the functional outcome using the Musculoskeletal Tumor Society (MSTS) scoring system were evaluated.
RESULTS
The average postoperative follow-up period was 53.64 months (range, 30 to 84 months). At the latest follow-up, all patients had no evidence of disease without metastases. One patient with local recurrence underwent revision surgery with fibula autograft reconstruction. The mean MSTS score was 93.45 ± 3.56.
CONCLUSIONS
Treatment of patients with PAOS of the posterior aspect of the distal femur with hemicortical resection and allograft reconstruction has satisfactory oncological and functional outcome and low complication rates.
PubMed: 35692235
DOI: 10.1155/2022/5153924 -
Radiology Dec 1996To evaluate the use of magnetic resonance (MR) imaging and computed tomography (CT) for predicting the histologic grade of parosteal osteosarcomas.
PURPOSE
To evaluate the use of magnetic resonance (MR) imaging and computed tomography (CT) for predicting the histologic grade of parosteal osteosarcomas.
MATERIALS AND METHODS
Sixty parosteal osteosarcomas were analyzed for tumor size and location, presence of a cleavage plane, intramedullary extension, soft-tissue mass (distinct from ossified mass), and the presence and pattern of ossification. Axial and longitudinal views were evaluated for specific osseous sites within the bone. Tumors were classified as low grade (grade 1) or high grade (grades 2-3).
RESULTS
There were 32 low-grade lesions and 28 high-grade lesions. Average maximal lengths of low- and high-grade tumors were 7.7 and 15.0 cm, respectively. A cleavage plane was present in 20 (62%) low-grade and 19 (68%) high-grade lesions. On cross-sectional images, intramedullary extension was present in 13 (41%) low-grade and 14 (50%) high-grade lesions. A focal soft-tissue mass distinct from the ossific matrix was identified in 25 (89%) high-grade lesions and in only two (6%) low-grade lesions. All 17 high-grade lesions evaluated with MR imaging were of predominantly high signal intensity on T2-weighted images.
CONCLUSION
A poorly defined soft-tissue component distinct from the ossific matrix is the most distinctive feature of high-grade parosteal osteosarcoma and may be an optimal site for biopsy.
Topics: Adolescent; Adult; Aged; Bone Neoplasms; Female; Femoral Neoplasms; Humans; Humerus; Magnetic Resonance Imaging; Male; Middle Aged; Osteosarcoma, Juxtacortical; Retrospective Studies; Tibia; Tomography, X-Ray Computed
PubMed: 8939240
DOI: 10.1148/radiology.201.3.8939240 -
Oral Surgery, Oral Medicine, and Oral... May 1977Parosteal osteosarcoma is a low-grade form of osteosarcoma that rarely affects the jaws. A case involving the maxilla of a 25-year-old man is presented, and four...
Parosteal osteosarcoma is a low-grade form of osteosarcoma that rarely affects the jaws. A case involving the maxilla of a 25-year-old man is presented, and four previously reported cases are reviewed.
Topics: Adult; Alveolar Process; Diagnosis, Differential; Humans; Male; Maxillary Neoplasms; Osteosarcoma
PubMed: 266153
DOI: 10.1016/0030-4220(77)90057-3 -
Skeletal Radiology Apr 2008Dedifferentiated parosteal osteosarcoma is characterized histologically by the admixture of low-grade fibroblastic osteosarcoma and a high-grade component typically...
Dedifferentiated parosteal osteosarcoma is characterized histologically by the admixture of low-grade fibroblastic osteosarcoma and a high-grade component typically resembling conventional osteosarcoma or malignant fibrous histiocytoma. We report an unusual distal femoral dedifferentiated parosteal osteosarcoma in which the dedifferentiated component resembled a giant cell tumor of bone. This phenotype is rarely described in the dedifferentiated component of a dedifferentiated parosteal osteosarcoma. The clinical, radiographic, and pathologic features of this unusual tumor are described to further expand the histologic spectrum of dedifferentiated parosteal osteosarcoma.
Topics: Adult; Biopsy, Needle; Bone Neoplasms; Diagnosis, Differential; Fatal Outcome; Femoral Neoplasms; Giant Cell Tumors; Humans; Magnetic Resonance Imaging; Male; Osteosarcoma, Juxtacortical; Phenotype; Tomography, Emission-Computed
PubMed: 18256826
DOI: 10.1007/s00256-007-0440-1 -
Cancer Jan 1993Low-grade intraosseous osteosarcoma is a rare variety of osteosarcoma and it is difficult to recognize.
BACKGROUND
Low-grade intraosseous osteosarcoma is a rare variety of osteosarcoma and it is difficult to recognize.
METHODS
A series of 10 patients with low-grade intraosseous osteosarcoma is reported. These patients were identified from the Istituto Rizzoli files, which includes approximately 1000 cases of osteosarcoma. Clinical data and radiographic and histologic features were studied.
RESULTS
The radiographic appearance confirmed malignancy in five patients and suggested it in two. A benign lesion was diagnosed in three patients. Three lesions resembled parosteal osteosarcoma, two appeared similar to fibrous dysplasia, and two had features of desmoplastic fibroma. A mixed histologic pattern was found in three other tumors. Recurrence after intralesional excision in all patients indicated the aggressive nature of this lesion. The development of metastases in two patients and progression in the grade of malignancy in one of these highlighted the malignant nature of the tumor.
CONCLUSIONS
The correct diagnosis would permit adequate treatment with wide surgical margins.
Topics: Adolescent; Adult; Bone Neoplasms; Female; Fibroma; Fibrous Dysplasia of Bone; Humans; Male; Middle Aged; Osteosarcoma; Radiography
PubMed: 8422626
DOI: 10.1002/1097-0142(19930115)71:2<338::aid-cncr2820710212>3.0.co;2-h -
International Journal of Paleopathology Jun 2018A case of potentially dedifferentiated parosteal osteosarcoma was found in the proximal humerus of an adult female buried in the late Anglo-Saxon cemetery of Cherry...
A case of potentially dedifferentiated parosteal osteosarcoma was found in the proximal humerus of an adult female buried in the late Anglo-Saxon cemetery of Cherry Hinton, Cambridgeshire, UK. Key features include a large, dense, lobulated mass attached to the medial metaphysis of the proximal humerus by a broad-based attachment, accompanied by cortical destruction and widespread spiculated periosteal reaction. Radiographic images confirm medullary involvement, lack of continuity between the cortex and external mass, a radiolucent cleavage plane and possible radiolucent zones within the bony masses. Differential diagnoses considered include osteochondroma, myositis ossificans, fracture callus, as well as the primary malignancies of osteosarcoma and chondrosarcoma, and their various subtypes. The macroscopic and radiographic analysis of the tumor is described and discussed within clinical and paleopathological contexts. One of only 19 uncontested examples of osteosarcoma from past human populations, most of which remain unconfirmed, this case represents what we believe to be the earliest, and probably singular, bioarcheological example of parosteal osteosarcoma in human history.
Topics: Female; Humans; Bone Neoplasms; Diagnosis, Differential; History, Medieval; Osteosarcoma, Juxtacortical
PubMed: 29776880
DOI: 10.1016/j.ijpp.2016.12.001 -
The Annals of Thoracic Surgery Jan 1998Comprising 1.6% of primary bone malignancies, parosteal osteosarcomas are rare. Rib parosteal osteosarcomas are even rarer, with only 2 cases in the literature. We...
Comprising 1.6% of primary bone malignancies, parosteal osteosarcomas are rare. Rib parosteal osteosarcomas are even rarer, with only 2 cases in the literature. We report a third such case, with a 32-month disease-free survival. Issues relevant to the management of rib parosteal osteosarcomas are discussed.
Topics: Adult; Bone Neoplasms; Female; Humans; Osteosarcoma, Juxtacortical; Ribs; Thoracic Neoplasms
PubMed: 9456137
DOI: 10.1016/s0003-4975(97)01200-9 -
Revista Do Hospital Das Clinicas 2003To report the case of a woman with a diagnosis of grade II (low grade) parosteal osteosarcoma with the occurrence of myocardial metastasis 13 years after resection, and...
PURPOSE
To report the case of a woman with a diagnosis of grade II (low grade) parosteal osteosarcoma with the occurrence of myocardial metastasis 13 years after resection, and to present a review of the existing literature on the subject.
METHODS
Description of the case and review of the literature.
CONCLUSION
The review leads to the conclusion that the occurrence of metastasis from parosteal osteosarcoma can occur in up to 38% of the cases, in spite of its relatively low aggressiveness. However, myocardial metastasis of a parosteal osteosarcoma is an event that was not found in the literature.
Topics: Adult; Bone Neoplasms; Female; Follow-Up Studies; Heart Neoplasms; Humans; Humerus; Myocardium; Osteosarcoma, Juxtacortical; Time Factors
PubMed: 12845365
DOI: 10.1590/s0041-87812003000200010 -
Pathology International Jul 2002An extraskeletal osteosarcoma histologically mimicking parosteal osteosarcoma arising in a 63-year-old female is described. The intramuscular lesion in the left lower...
An extraskeletal osteosarcoma histologically mimicking parosteal osteosarcoma arising in a 63-year-old female is described. The intramuscular lesion in the left lower thigh was a 7 x 4 cm, well-defined mass with marked central calcification and ossification. The tumor was composed predominately of a centrally located osteocartilaginous component and a peripheral, non-osseous fibrous component. The former was characterized by a complex interanastomosing pattern of woven-bone trabeculae with small osteocytes and a minor cartilaginous element. The intratrabecular stroma consisted of benign-appearing fibroblasts. The peripheral fibrous part was characterized by fascicular and interlacing proliferations of spindle cells with mild atypia, rare mitosis and low to moderate cellularity. There were a few scattered foci of proliferating pleomorphic cells, constituting 5% of the tumor, indicating high-grade transformation. There was no evidence of zoning phenomena, cortical erosion, periosteal reaction or intramedullary involvement. The patient is well without recurrence or metastasis at 12 months follow up. This soft tissue neoplasm, mimicking parosteal osteosarcoma, should be distinguished from other bone-forming tumors or tumor-like lesions with which they may be confused. Pathologists and physicians should know the existence of this type of extraskeletal osteosarcoma and treat it as a high-grade extraskeletal osteosarcoma.
Topics: Bone Neoplasms; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Middle Aged; Osteosarcoma; Soft Tissue Neoplasms; Thigh; Tomography, X-Ray Computed
PubMed: 12167110
DOI: 10.1046/j.1440-1827.2002.01372.x -
Journal of Medical Case Reports Jan 2019Masses which develop on the surface of the rib bones are rare. The differential diagnosis includes benign and malignant lesions.
INTRODUCTION
Masses which develop on the surface of the rib bones are rare. The differential diagnosis includes benign and malignant lesions.
CASE PRESENTATION
A 23-year-old European woman presented at an out-patient clinic with a 9-month history of a painless swelling on the right posterolateral side of her chest wall. The case reported here is of a very rarely seen parosteal osteosarcoma of the rib that was treated with wide resection and chest wall reconstruction. There was no evidence of local recurrence or distal metastasis after a 1-year follow-up.
CONCLUSION
Parosteal osteosarcoma is a locally aggressive malignant tumor, and resection with a wide margin is the most appropriate treatment. Correct diagnosis of parosteal osteosarcoma is challenging for an orthopedic surgeon. Although rare, in the differential diagnosis of lesions located on the ribs, parosteal osteosarcoma should be considered and a systematic diagnostic approach should be taken.
Topics: Bone Neoplasms; Bone Plates; Female; Humans; Osteosarcoma, Juxtacortical; Plastic Surgery Procedures; Ribs; Surgical Mesh; Thoracic Wall; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
PubMed: 30670083
DOI: 10.1186/s13256-018-1958-7