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Insights Into Imaging Jun 2023Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is... (Review)
Review
Bizarre parosteal osteochondromatous proliferation (BPOP) is a surface-based bone lesion belonging to the group of benign chondrogenic tumors. The aim of this review is to familiarize the readers with imaging features and differential diagnosis of BPOP, also addressing pathological presentation and treatment options. The peak of incidence of BPOP is in the third and fourth decades of life, although it can occur at any age. Hands are the most common location of BPOP (55%), followed by feet (15%) and long bones (25%). On imaging, BPOP appears as a well-marginated mass of heterotopic mineralization arising from the periosteal aspect of the bone. Typical features of BPOP are contiguity with the underlying bone and lack of cortico-medullary continuity, although cortical interruption and medullary involvement have been rarely reported. Histologically, BPOP is a benign bone surface lesion characterized by osteocartilaginous proliferation with disorganized admixture of cartilage with bizarre features, bone and spindle cells. Differential diagnosis includes both benign-such as florid reactive periostitis, osteochondroma, subungual exostosis, periosteal chondroma and myositis ossificans-and malignant lesions-such as periosteal chondrosarcoma and surface-based osteosarcoma. Treatment consists of surgical resection. Local recurrences are common and treated with re-excision.Critical relevance statement Bizarre parosteal osteochondromatous proliferation is a benign mineralized mass arising from the periosteal aspect of bone cortex. Multi-modality imaging characteristics, pathology features and differential diagnosis are here highlighted to familiarize the readers with this entity and offer optimal patient care.
PubMed: 37336832
DOI: 10.1186/s13244-023-01455-0 -
Indian Journal of Otolaryngology and... Jun 2023: Surface osteosarcomas represent around 3-6% of all osteosarcomas, which include the parosteal (low-grade), periosteal (intermediate-grade) and high-grade surface...
: Surface osteosarcomas represent around 3-6% of all osteosarcomas, which include the parosteal (low-grade), periosteal (intermediate-grade) and high-grade surface osteosarcomas. The classical location is the femur, followed by tibia and humerus. Parosteal osteosarcoma is the most common type of surface osteosarcoma. To date, 26 cases of parosteal osteosarcoma affecting the jaws have been reported, with most cases following an evolution time of several months to years, clinically favoring a benign osseous or fibro-osseous lesion. : Here, we report a 39-year-old female who was referred presenting a maxillary tumoral mass 5 years ago, clinically diagnosed as osteoma. After clinical, imaginological and histopathological analysis, a diagnosis of parosteal osteosarcoma was made. : Thus, parosteal osteosarcoma should also be considered in the differential diagnosis of benign-appearance, bone-forming nodular lesions affecting the jaws.
PubMed: 37274972
DOI: 10.1007/s12070-022-03373-x -
Orthopedic Research and Reviews 2023The treatment of low-grade osteosarcomas is surgical resection with wide margins. In instances of dedifferentiation, a therapeutic paradigm similar to that of... (Review)
Review
The treatment of low-grade osteosarcomas is surgical resection with wide margins. In instances of dedifferentiation, a therapeutic paradigm similar to that of conventional high-grade osteosarcoma has not been adequately evaluated in these neoplasms. The main objective of this review was to define whether the addition of chemotherapy to surgical treatment has an impact on the survival of patients with dedifferentiated low-grade osteosarcomas. Secondary objectives were to observe the degree of histological response to neoadjuvant chemotherapy and to describe the percentage of de novo dedifferentiation. A systematic search of articles including dedifferentiated low-grade osteosarcomas, published between 1980 and 2022 was carried out in the PubMed, Cochrane and Scielo databases. A qualitative synthesis of the results was performed. Twenty-three articles comprising 117 patients were included. The survival of patients treated with surgery alone and surgery with chemotherapy was not statistically significant between the two groups. A good histological response was seen in 20% of specimens treated with neoadjuvant chemotherapy. De novo dedifferentiation was seen in approximately a fifth of low-grade osteosarcomas. The evidence available suggests that the addition of chemotherapy does not have an impact on the survival of patients with low-grade dedifferentiated osteosarcomas.
PubMed: 37143718
DOI: 10.2147/ORR.S404146 -
Malaysian Orthopaedic Journal Mar 2023Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell...
Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well-differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.
PubMed: 37064628
DOI: 10.5704/MOJ.2303.023 -
Indian Journal of Thoracic and... Mar 2023Myositis ossificans of the chest wall is extremely unusual with fewer than a dozen reported cases. In addition, the occurrence in children younger than 10 years is...
Myositis ossificans of the chest wall is extremely unusual with fewer than a dozen reported cases. In addition, the occurrence in children younger than 10 years is extremely rare. We report a case of an 8-year-old male who presented with painful and progressively enlarging left-sided chest wall mass. The tumor showed close histo-morphological mimicry with osteosarcoma. Moreover, the characteristic radiographic findings of myositis ossificans were absent. The age of the patient and the absence of attachment to the rib helped exclude extra-skeletal and parosteal osteosarcomas, respectively. The patient was doing well 4 months after surgery.
PubMed: 36785605
DOI: 10.1007/s12055-022-01463-7 -
Pathology, Research and Practice Feb 2023To present our experience on osteosarcomas of the hands and review the existing literature pertaining osteosarcomas in this extremely rare location. (Review)
Review
AIM
To present our experience on osteosarcomas of the hands and review the existing literature pertaining osteosarcomas in this extremely rare location.
METHODS
and results: Seven cases of osteosarcomas of the hands were reviewed, and a literature search of all primary osteosarcomas of the hands was performed. All tumors occurred in adults (mean age, 41 years) and were located mainly around the metacarpophalangeal joints. All patients presented with localized long-lasting pain as main symptom. The mean size at diagnosis was 33 mm. Three tumors were low-grade central osteosarcomas, 1 low-grade central chondroblastoma-like osteosarcoma and 3 high-grade osteosarcomas. All tumors were positive for mouse double-minute 2 homolog (MDM2) immunohistochemistry. Three cases yielded results with fluorescence in-situ amplification for MDM2 (12q15)/CEP12. At last follow-up, one patient with a high-grade osteosarcoma was dead of disease. The literature review revealed similar demographic and site distribution of osteosarcomas within the hands than our series and an unusually high proportion of low-grade central and parosteal osteosarcomas when compared to the proportion of these infrequent neoplasms in the whole skeleton.
CONCLUSIONS
osteosarcomas of hands present in older individuals compared to the population affected by conventional osteosarcomas of all sites. Importantly from a diagnostic, therapeutic and prognostic points of view, around 40% of osteosarcomas of the hands are low-grade osteosarcomas of the central or parosteal types.
Topics: Animals; Mice; Bone Neoplasms; Osteosarcoma; Prognosis; Immunohistochemistry
PubMed: 36716613
DOI: 10.1016/j.prp.2023.154326 -
International Journal of Surgical... Oct 2023Periosteal fasciitis is a subtype of nodular fasciitis originating from the periosteum. The diagnosis can be challenging and requires radiologic-pathologic correlation....
Periosteal fasciitis is a subtype of nodular fasciitis originating from the periosteum. The diagnosis can be challenging and requires radiologic-pathologic correlation. Advances in molecular analysis confirmed that nodular fasciitis and its related lesions harbor a gene rearrangement with one of the several potential partners. Herein, we report a case of periosteal fasciitis with metaplastic bone formation detected incidentally during a radiologic survey for breast carcinoma. Radiologic examination revealed a 2.4 cm, heterogeneous, avidly enhancing lesion of the right femoral distal metaphysis concerning for low-grade periosteal chondrosarcoma. Histological examination of a core needle biopsy revealed a tumor composed of bland spindle cells with myofibroblastic and osteoblastic phenotypes admixed with immature bone and cartilaginous elements. Molecular analysis revealed a novel fusion that helped arrive at the right diagnosis and further expands the molecular profile of -associated neoplasms.
Topics: Humans; Proto-Oncogene Proteins; Gene Rearrangement; Ubiquitin Thiolesterase; Fasciitis; Fibroma; Bone Neoplasms; Nuclear Proteins
PubMed: 36694417
DOI: 10.1177/10668969221150369 -
Cureus Dec 2022Osteosarcoma is a tumour that can originate in any bone and is the most frequent malignant tumour of the skeleton. It typically develops close to the metaphyseal growth...
Osteosarcoma is a tumour that can originate in any bone and is the most frequent malignant tumour of the skeleton. It typically develops close to the metaphyseal growth plates in the limbs' long bones. The three most prevalent places are the femur, tibia, and humerus. Additional locations include the pelvis, skull, and jaw. Diaphyseal osteosarcoma involves a smaller population and is highly uncommon. Conventional kinds of osteosarcoma, such as osteoblastic, chondroblastic, and fibroblastic types, as well as telangiectatic, multifocal, parosteal, and periosteal types, are some of the variations of the disease. The primary bone tumour (cancerous) is generated by the formation of immature bone and primarily affects adolescents. We present a case of a 45-year-old menopausal female with left tibial osteosarcoma of the proximal 1/3 diaphysis infected with maggots and complaints of left knee pain and tingling.
PubMed: 36686136
DOI: 10.7759/cureus.32718 -
Acta Ortopedica Brasileira 2022Evaluate risk factors related to clinical evolution and dedifferentiation of parosteal (juxtacortical) osteosarcoma to high-grade osteosarcoma.
OBJECTIVE
Evaluate risk factors related to clinical evolution and dedifferentiation of parosteal (juxtacortical) osteosarcoma to high-grade osteosarcoma.
METHODS
Retrospective cohort study performed over a period of 25 years, using data from medical records of patients diagnosed with parosteal osteosarcoma. The data were submitted to statistical analysis by Fisher's exact test and Student's t-test.
RESULTS
Of the 326 patients treated for osteosarcoma, we identified 17 patients diagnosed with parosteal osteosarcoma. Of these, 4 (23.5%) were not actually diagnosed with parosteal osteosarcoma and 4 did not have the minimum data required for analysis, being excluded from the study. Of the 9 patients studied, we observed that 3 (33.3%) evolved with tumor dedifferentiation to high-grade osteosarcoma. Moreover, 2 (66.7%) had local recurrence and 2 (66.7%) metastases.
CONCLUSION
Age, sex, and the tumor size were not directly related to the dedifferentiation from parosteal osteosarcoma to high-grade osteosarcoma. The most aggressive clinical evolution - presence of local recurrences and metastasis - in parosteal osteosarcoma occurred in tumors with dedifferentiation, however, we cannot associate each other as cause and effect, but as related factors.
PubMed: 36451789
DOI: 10.1590/1413-785220223005e257493 -
Skeletal Radiology Mar 2023Periosteal chondrosarcoma is a rare tumor. It can be difficult to diagnose radiographically and pathologically and can be confused with periosteal osteosarcoma; however,...
Periosteal chondrosarcoma is a rare tumor. It can be difficult to diagnose radiographically and pathologically and can be confused with periosteal osteosarcoma; however, the treatment of these two lesions is quite different. Increased awareness of imaging features of this lesion, particularly those that can help differentiate it from other surface-based tumors, can help one recognize this entity. We report the case of a periosteal chondrosarcoma in a young woman, highlighting the diagnostic imaging features of this disease, and her treatment with a joint-sparing geometric resection of the distal femur, using patient-specific 3D-printed cutting guides and matched allograft reconstruction.
Topics: Female; Humans; Bone Neoplasms; Chondrosarcoma; Osteosarcoma; Osteosarcoma, Juxtacortical; Femur; Soft Tissue Neoplasms
PubMed: 36318319
DOI: 10.1007/s00256-022-04216-0