Radiological study of 12 high-grade surface osteosarcomas

Abstract

High-grade surface osteosarcomas are often characterized by the presence of an ossified mass contiguous with and originating from the cortical bone with no or minimal marrow involvement.

Osteosarcoma

“…There usually is very little or no medullary invasion by the tumor in conventional radiography, although CT and MRI demonstrate occasional small foci of marrow involvement. 52 If medullary invasion were a constant feature, it would be more difficult to make a case pathologically for the lesion to have originated from the bony surface. On the other hand, because this tumor is considered to have the same malignant potential as conventional osteosarcoma, it is logical to occasionally have some degree of localized invasion of the cortex and endosteum.…”

Surface primary bone tumors: Systematic approach and differential diagnosis

“…This tumor usually shows dense to moderate mineralization with a fluffy and immature appearance, predominantly at the base of the lesion. The tumor has a broad base attached to the underlying bone, and a periosteal reaction is commonly present [34]. Circumferential bone involvement is usually more extensive in this tumor than in other forms of surface osteosarcomas (Fig.…”

“…Circumferential bone involvement is usually more extensive in this tumor than in other forms of surface osteosarcomas (Fig. 12) [12,34].…”

“…Unlike parosteal osteosarcomas, high-grade surface osteosarcoma predominates in the anteromedial portion of the diaphysis, with tibial lesions being most commonly proximal and femoral lesions being more frequent in the middle to distal portions of the diaphysis [12,34].…”

“…Highgrade surface osteosarcoma is the most difficult lesion to distinguish from periosteal osteosarcoma because both are usually diaphyseal and show a perpendicular periosteal reaction. However, high-grade surface osteosarcoma often involves the entire circumference of the cortex and is more likely to show medullary invasion [34]. Periosteal chondroid tumors are surface bone masses with well-defined borders, typically metaphyseal in location, and contain curvilinear calcifications along the periphery of the cartilage lobules [5].…”