Primary cutaneous osteoblastic osteosarcoma: a case report and review of the current literature

Abstract

Osteosarcoma is a malignant bone-forming tumour that typically arises within the metaphysis of long bones. Extraskeletal osteosarcoma is a rare variant that usually arises in the deep soft tissues, especially in the legs. We report a 65-year-old white man with an ulcerated, nodular lesion of the forearm. Based on the histological features and immunohistochemical profile of the tumour, a diagnosis of osteoblastic osteosarcoma was made. Osteosarcoma arising in the skin is a rare condition that has seldom been reported in the English literature.

Cutaneous Hematopathology

“…While approximately 95 % of skeletal OS metastasize to the lung, metastases to the skin do occur, either exclusively or -more commonly -in addition to pulmonary metastases (Collier et al 2003 ;Ragsdale et al 2011 ;Setoyama et al 1996 ). Extraskeletal osteosarcomas (ESOS) comprise a small fraction of all osteosarcomas (approximately 2-4 %), and only 1-2 % of all soft tissue sarcomas collectively (Riddle et al 2009 ;Salamanca et al 2008 ). Case reports of ESOS arising as a primary neoplasm from the dermis and subcutis exist (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Llamas-Velasco et al 2013 ;Massi et al 2007 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ).…”

“…Extraskeletal osteosarcomas (ESOS) comprise a small fraction of all osteosarcomas (approximately 2-4 %), and only 1-2 % of all soft tissue sarcomas collectively (Riddle et al 2009 ;Salamanca et al 2008 ). Case reports of ESOS arising as a primary neoplasm from the dermis and subcutis exist (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Llamas-Velasco et al 2013 ;Massi et al 2007 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ). Risk factors for primary cutaneous osteosarcoma are similar to those for deep-seated ESOS and include a history of prior irradiation, chemotherapy, and trauma; several cutaneous OS, in fact, have arisen within remote scars (Drut and Barletta 1975 ;Kuo 1992 ;Park et al 2011 ;Riddle et al 2009 ).…”

“…ESOS most commonly occurs within the deep soft tissues of the extremities, and unlike its skeletal counterpart, ESOS primarily affects middle-aged to elderly adults Riddle et al 2009 ). Like deep-seated ESOS, primary cutaneous OS have also been identifi ed in the extremities of older adults (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ).…”

“…ESOS most commonly occurs within the deep soft tissues of the extremities, and unlike its skeletal counterpart, ESOS primarily affects middle-aged to elderly adults Riddle et al 2009 ). Like deep-seated ESOS, primary cutaneous OS have also been identifi ed in the extremities of older adults (Drut and Barletta 1975 ;Kobos et al 1995 ;Kuo 1992 ;Park et al 2011 ;Riddle et al 2009 ;Salamanca et al 2008 ). Interestingly, cutaneous OS, whether metastatic or primary in origin, demonstrates a particular proclivity for the scalp (Collier et al 2003 ;Massi et al 2007 ;Park et al 2011 ;Ragsdale et al 2011 ).…”

Primary cutaneous osteosarcoma of the scalp

“…Extraskeletal osteosarcomas (ESOS) are rare, with only 2%–4% of osteosarcomas identified outside the skeletal system 1. Cutaneous ESOS are even rarer.…”