Local recurrence of a parosteal osteosarcoma 21 years after incomplete resection

Combalía, Andrés; Muñoz-Mahamud, Ernesto; Palacin, Antonio Otal; Pomés, Jaume; López, Vicente Santa-María

doi:10.5732/cjc.011.10090

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…[22][23][24] The longest recorded recurrence was 21 years after the initial operation. [25] Therefore, for low-grade malignant tumors of PO, the follow-up time should be long to facilitate close observation. If PO dedifferentiation occurs, it is the same as classic osteosarcoma and is treated in the same manner, with comprehensive treatment dominated by neoadjuvant chemotherapy and surgery.…”

Section: Discussionmentioning

confidence: 99%

Parosteal osteosarcoma of the fibula in a middle-aged patient

Chen

Xu²,

Zhang³

et al. 2019

Medicine

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Rationale:Parosteal osteosarcoma (PO) is relatively rare, accounting for about 1% of primary malignant bone tumors and 4% of all osteosarcomas. Onset is generally at approximately 20 to 40 years of age; the distal posterior surface of femur is the most common site, accounting for more than 60% cases. However, PO in middle-aged or elderly patients is extremely rare and PO occurring in the fibula is even rarer. To our knowledge, this is the first case of PO occurring in the fibula of a middle-aged adult.Patient concerns:We present a case of a 47-year-old female who had a lateral mass on her left knee for 3 months with no obvious cause.Diagnoses:The patient was initially diagnosed with a proximal left fibula tumor via x-ray scan at a local hospital. Subsequently, osteochondroma was highly suspected through computed tomography (CT) and magnetic resonance imaging (MRI) obtained at our hospital. Finally, the postoperative pathological report confirmed PO.Interventions:She underwent a complete resection of the left fibula tumor and received postoperative adjuvant chemotherapy.Outcomes:The patient recovered well and was discharged on the 10th day after admission. Additionally, there was no evidence of recurrence at the 4-year follow-up after surgery.Lessons:In middle-aged or elderly patients, early diagnosis of PO in the fibula is difficult and misdiagnosis or missed diagnosis is common. In clinical practice, PO is uncommon in middle-aged or elderly patients, occurs more rarely in the peroneal bone, and should be carefully identified. CT and MRI are essential for diagnosis, with pathological examination being effective for confirmation. Because of the limited reports of PO of the fibula in middle-aged or elderly adults, the present case raises awareness of this rare condition.

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Section: Discussionmentioning

confidence: 99%

Parosteal osteosarcoma of the fibula in a middle-aged patient

Chen

Xu²,

Zhang³

et al. 2019

Medicine

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“…Most eases develop on the lower posterior femoral shaft, although some oeeur on other long bones [2]. Most eases develop on the lower posterior femoral shaft, although some oeeur on other long bones [2].…”

Section: Discussionmentioning

confidence: 99%

A Challenging Case of Locally Aggressive Polyostotic Fibrous Dysplasia

Mlika¹,

Chelli-Bouaziz²,

Boudaya³

et al. 2013

Tur Toraks Der

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Fibrous dysplasia (FD) is a benign lesion observed mainly in children and young adolescents. Although benign, it can sometimes Özet be challenging to discriminate these lesions from well-differentiated malignant tumours. Here, we describe a confusing case of asymptomatic locally aggressive polyostotic FD in a 49-year-old woman followed for a molar pregnancy. The case was particular due to the rare localization of FD in the ribs and vertebrae, and it posed a diagnostic dilemma with parosteal osteosarcoma. This case highlights the difficulty of distinguishing FD from a welldifferentiated malignant tumour, especially when facing artefacts arising from the décalcification procedure.

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“…The incidence of medullary involvement and transformation into high grade tumors are interrelated and increase with repeated recurrence but the incidence of metastasis remains low except for dedifferentiated POs (DPOs) which behave similar to high grade sarcoma with metastatic rate of up to 50% has been observed. [2,3,8,10,11,16,22,23] DPOs comprise 16% of POs. The sarcomatous component is mostly fibroblastic osteosarcoma, followed by fibrosarcoma, malignant fibrous histiocytoma, osteoblastic and chondroblastic osteosarcoma.…”

Section: Discusssionmentioning

confidence: 99%

Challenges and pitfalls in diagnosis of Parosteal Osteosarcoma: A clinicopathologic study of 23 cases

Tariq

Din

Ahmed

et al. 2016

JST

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Objective: Parosteal Osteosarcoma (PO) is an uncommon variant of osteosarcoma. Diagnosing PO is important due to its malignant nature but the diversity of histologic features makes it challenging by adding a number of soft tissue, bony and cartilaginous lesions into the list of differential diagnosis. Our aim was to study the clinicopathologic and histological features of PO with emphasis on features helpful in its discrimination from other mimicking lesions. Methods: We reviewed 23 cases of PO diagnosed in our institution between January 2001 and August 2015. Results: Femur was the most commonly involved bone (68.2%) along with other long bones and rib in a single case. Soft tissue component was graded as Grade1 in 9(39%), Grade2 in 8(34.7%) and Grade3 in 4(17.3%) cases. Bony component was seen either in combination of or exclusively as parallel streams and interconnected trabeculae (mosaic-pattern). Out of 9 cases with cartilage component, 3 showed a cartilage cap. 2(8.6%) cases showed dedifferentiation into osteosarcoma. Conclusion: PO should always be considered in the differential diagnosis of every lesion arising from the bone surface. Knowledge of the variations in histologic features helps to reach the correct diagnosis which should never be made without radiological correlation.

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Local recurrence of a parosteal osteosarcoma 21 years after incomplete resection

Cited by 4 publications

References 10 publications

Parosteal osteosarcoma of the fibula in a middle-aged patient

Parosteal osteosarcoma of the fibula in a middle-aged patient

A Challenging Case of Locally Aggressive Polyostotic Fibrous Dysplasia

Challenges and pitfalls in diagnosis of Parosteal Osteosarcoma: A clinicopathologic study of 23 cases

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