Parosteal Osteosarcoma: A Benign-Looking Tumour, Amenable to a Variety of Surgical Reconstruction

Abstract

Osteosarcoma arising from cortical surface is classified into parosteal, periosteal and high-grade surface osteosarcoma. Along the spectrum, parosteal osteosarcoma occupies the well-differentiated end. It is a relatively rare disease entity, comprised only 4% of all osteosarcomas and barely reported in the literature. The objective of this study is to describe cases of parosteal osteosarcoma as well as a variety of treatment options amenable to such entity. Six cases of parosteal osteosarcoma were identified based on histopathological reports in a tertiary referral hospital in Jakarta, Indonesia between January 2001 and December 2019. The mean age was 29.8 years old; four of them (66.7%) were male. Distal end of femur was the most commonly involved bone (five cases, 83.3%). The patients were treated with wide excision followed by several different reconstruction methods: replacement with endoprosthesis, extracorporeal irradiation, knee arthrodesis, or prophylactic fixation. One of our patients presented with dedifferentiated component, and therefore was treated by limb ablation. While two cases died of pulmonary metastasis, other patients reported fair to excellent functional outcome.

Allograft reconstruction for large parosteal osteoma of the clavicle: a case report

“…Primary clavicle tumor and tumorous lesions are rare, and the majority of studies were case reports [ 2 ]. Since osteomas are benign lesions, it is important to differentiate them from malignant lesions like parosteal osteosarcoma or parosteal chondrosarcoma [ 3 ]. In our case, bone scan revealed an active bone lesion, and the clinical diagnosis of the radiology department was parosteal osteosarcoma due to suspicious involvement of the subscapularis enhancing soft tissue portion and deviating subclavian vein, making it difficult to determine treatment.…”

Hemicortical Resection and Biological Reconstruction using Allograft for Parosteal Osteosarcoma of the Distal Femur. A Case Series

“…After wide tumor excision of the distal femur, the most common location of PAO, endoprosthesis or different reconstruction techniques can be used. Due to the low grade of the tumor and to the young age of the patients hemicortical resection and reconstruction of the bone defect using polymethyl methacrylate (PMMA) or biological materials such as bular autografts, allografts or pasteurized/autoclaved/irradiated host bones, with or without prophylactic xation have been reported with good oncological and functional outcome [11][12][13][14].…”

Case Report: Ossified Subperiosteal Hematoma in the Humerus of a Lacrosse Player

“…Myositis ossificans is a self-limited, benign ossifying soft tissue mass that often presents within muscle [19]. Histologically, conventional parosteal osteosarcoma demonstrates irregular bony trabeculae and blandappearing spindle cells within a fibrous stromal tissue [25].…”