High grade surface osteosarcoma Radiology

Microscopic features of high-grade surface osteosarcomas are those of a conventional high-grade osteosarcoma 1. Immunohistochemistry. Irrelevant for diagnosis 1. Radiographic features. General imaging features of high-grade surface osteosarcomas are the following 1,2,5: the tumour arises from the bony surfaces; dense ossification Osteosarcoma. Osteosarcomas are malignant bone-forming tumors . They are the second most common primary bone tumor after multiple myeloma, accounting for ~20% of all primary bone tumors. They can be classified into primary and secondary forms, as well as histologic types, of which conventional osteosarcoma is the most common High-Grade Osteosarcoma of the Surface Lateral radiograph of the knee and axial T1 MR image. The tumor forms bone, mainly develops in the soft tissues, but starts from the cortex, which has a limited lysis. Minimal bone extension is visible on M High grade surface osteosarcoma is a type of high grade osteosarcoma that develops on the surface of the bone from the outer cortex. There is none to minimal medullary involvement The microscopic pathology is the same as a conventional osteosarcoma and it has the same high potential for metastasizing Background: High-grade surface osteosarcoma is an extremely rare subtype of osteosarcoma. The treatment outcome for this tumor varies in different centers. Methods: This was a retrospective study of high-grade surface osteosarcoma; clinical, radiological, and histological materials were reviewed. Results: We studied 23 patients (16 males, seven females); median age was 24 years old

Parosteal osteosarcoma (par-OS) is the commonest sub-type of surface osteosarcoma, representing approximately 4-5% of all osteosarcomas [11, 17, 26].It arises from fibroblasts of the outer fibrous periosteal layer [7, 11], and is the most differentiated of the surface osteosarcomas being associated with the best prognosis [15, 26, 27].While a range of ages have been described, par-OS most. High-Grade Surface Osteosarcoma High-grade surface OS is rare, accounting for 0.4% of all OS cases (2), and is the least common type of juxtacortical OS. The tumor affects patients in the 2nd and 3rd decades of life (20) CONCLUSION: The radiologic appearance of periosteal osteosarcoma is a broad-based surface soft-tissue mass causing extrinsic erosion of thickened underlying diaphyseal cortex and perpendicular periosteal reaction extending into the soft-tissue component. Reactive marrow changes are commonly seen at MR imaging, but true marrow invasion is rare Osteosarcoma is a malignant, primary, osteoid-forming spindle cell neoplasm of bone with a typical clinical presentation and radiographic appearance. Several histologic subtypes exist that may present with variable imaging appearances. Interpretation of a bone lesion must be performed in light of patient age and location

Osteosarcoma Radiology Reference Article Radiopaedia

almost all osteosarcomas are high grade tumors (grow quickly and have a high likelihood of spreading/metastasizing) exceptions: well differentiated intraosseous osteosarcomas and parosteal osteosarcomas--both are low grade tumors (these grow slowly and rarely spread/metastasize periosteal, high-grade surface, telangiectatic, small cell, low-grade central) and a variety of benign and malignant diagnostic entities that mimic them. Juxtacortical Osteosarcoma Juxtacortical or surface OS refers to OS origi-nating from the surface of bone. It is primarily associated with the periosteum, with variable medullary canal. Intracortical Osteosarcoma High grade osteosarcoma confined to the cortex of a High grade osteosarcoma confined to the cortex of a long bonelong bone Very rare; handful of casesVery rare; handful of cases Age: 10Age: 10--30 yrs30 yrs Sites: Diaphysis of femur or tibiaSites: Diaphysis of femur or tibia Radiology: Radiology

High-Grade Osteosarcoma of the Surface Radiology Ke

Bone - High grade surface osteosarcoma. This website is intended for pathologists and laboratory personnel but not for patients Periosteal osteosarcoma arise from the inner germinative layer of periosteum. Cytologic grade of this tumor is higher than parosteal osteosarcoma and lower than conventional osteosarcomas, so it is considered as intermediate grade osteosarcoma (grade 2). It predominantly contains chondroid matrix High-grade surface osteosarcoma . High-grade surface osteosarcoma (HGSOS) constitutes less than 1% of all OS and manifests as a surface lesion with a high-grade appearance histologically . Local growth is accelerated in HGSOS more than in parosteal osteosarcoma. Radiology 179, 247-252. [Google Scholar] 43 Treatment General principles: (based on ESMO-guidelines) Curative treatment of high-grade osteosarcoma consists of chemotherapy and surgery. Multimodal treatment of high-grade localised osteosarcoma increases DFS from only 10-20% to >60% when compared to surgery alone. Low-grade central and parosteal osteosarcoma are malignancies with a lower.

Objective: The purpose of our study was to report the imaging characteristics of 12 high-grade surface osteosarcomas, diagnosed, staged, treated and followed up in a single institution. Design and patients: There were 3 females and 9 males ranging in age from 15 to 34 years (mean 20 years) Telangiectatic osteosarcoma is a variant of an intramedullary high grade osteosarcoma. Accounts for 3% of osteosarcomas Telangiectatic osteosarcoma is extremely lytic on X-rays. It demonstrates very little osteoid production Radiology along with High-grade surface osteosarcoma is least common type of osteosarcoma and accounts for 10% of juxtacortical osteosarcomas. It usually manifests in second and third decade of life. Pathologically, it is high grade like conventional osteosarcoma. Radiologically, it affects the diaphysis or metadiaphysis of the long bones. Chondroid matrix in up to 15% of tumor. ABC component 5-15% of tumors. The tumor is composed of chondroblasts that have a distinct, thick cell membrane. The thick cell membrane gives it a Chicken Wire Fence Appearance, especially when the cell membranes are calcified. Roll over the images for more information Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - High-Grade Surface Osteosarcoma. link. Bookmarks (0) Musculoskeletal. Diagnosis. Non-Traumatic Disease. Osseous Tumors and Tumor-Like Conditions. Bone-Forming Tumors

High-grade surface The death rates per 100 patient-years, correlated with histologic group and calculated by Taylor et al. ( 33 ), are shown in bold type, and the 5-year survival rates from the European Osteosarcoma Intergroup ( 34 ) are in parenthesis 8. High-grade surface osteosarcoma. This is a high-grade osteosarcoma with similar histological features to those of conventional intramedullary osteosarcoma. The tumor grows on the surface and lacks significant medullary involvement. Radiographically it mimics periosteal osteosarcoma, except it has cumulus cloud-like patterns of mineralization Osteosarcoma is the most common primary malignant tumor of bone, excluding plasma cell myeloma. Approximately 75% of all osteosarcomas are of the classic or conventional type, and the remaining 25% comprise the osteosarcoma variants, which are the subject of this article. The variants are a heterogeneous group of osteosarcomas with a range of different imaging and behavioral features Histological grade of malignancy is the main point to assess in surface osteosarcoma since it determines treatment and prognosis. Low grade lesions should be treated by wide resection, while high grade lesions need more aggressive surgical approach associated to post operative chemotherapy

Surface sarcomas are usually of a lower grade compared with intramedullary variants, leading to differences in management. Osteosarcoma arising from the cortical surface of the bone is termed juxtacortical or surface osteosarcoma and includes three distinct entities: parosteal, periosteal, and high-grade surface osteosarcoma Case report: primary high grade surface osteosarcoma. Cheung H(1), Lau RL, Hsu SY. Author information: (1)Department of Radiology, Princess Margaret Hospital, Kowloon, Hong Kong The diagnosis of high-grade surface osteosarcoma, just as with other bone sarcomas, should be based on clinical, radiological, and pathological examination. In our series, the local recurrence rate was 10% (2/20). A wide surgical margin is essential for local control of the tumor; our study showed the same result High-grade surface osteosarcoma (abstr). Lab Invest 1983; 48:94A-95A. Google Scholar; 43 Wold LE, Unni KK, Beabout JW, Pritchard DJ. High-grade surface osteosarcomas. Am J Surg Pathol 1984; 8:181-186. Crossref, Medline, Google Scholar; 44 Vanel D, Picci P, De Paolis M, Mercuri M. Radiological study of 12 high-grade surface osteosarcomas

High Grade Surface Osteosarcoma : Bone Tumor Cance

High grade surface osteosarcoma is a high grade osteosarcoma arising from the surface of the bone. Extremely rare (<1 % of all osteosarcomas), it has the clinical presentation, demographic distribution, and prognosis of conventional osteosarcoma. The most common site of involvement is the midshaft of the femur I NTRODUCTION. Osteosarcoma is defined as the primary malignant mesenchymal bone tumor where the malignant tumor cells directly form the osteoid or bone or both. 1,2,3,4,5,6,7,8,9,10,11,12 Demonstration of osteoid directly formed by the malignant cells in histopathology is essential for making the diagnosis of osteosarcoma. 2,3 Although the exact cause of osteosarcoma is still unknown, defects.

High-Grade Surface Osteosarcoma: Clinical Features and

Radiology is Essential for bone tumors! Skeleton < 30 years > 30 years Axial (skull, vertebrae, pelvis) High-grade surface osteosarcoma—histologically high-grade osteosarcoma, but arising on the surface of the bone, without substantial intraosseous involvement Osteosarcoma Variants . Radiation-induced osteosarcomas have the radiologic appearance and biologic behavior of conventional high-grade intramedullary osteosarcomas (Fig. 8.4). Approximately 5% of osteosarcomas are postirradiation in etiology. Osteosarcoma is the most common type of postirradiation musculoskeletal sarcoma High grade surface osteosarcoma is a rare subtype of osteosarcoma arising on the surface of bone, accounting for only 8.9% of surface osteosarcomas at the study institution. METHODS. This study reviews 46 cases of high grade surface osteosarcoma, com-prised of 13 cases from the Mayo Clinic files and 33 from the authors' files Osteosarcoma of bone is divided into conventional, telangiectatic, small cell, low-grade, secondary, parosteal, periosteal, and high-grade surface variants.9 These entities can be divided by their apparent origin from the intramedullary cavity or the surface of the bone. The histologic diagnosis of conventional osteosarcoma i Rare types of osteosarcoma include the periosteal and high-grade surface variants, as well as secondary and multifocal osteosarcoma (osteosarcomatosis). CT and MRI are the imaging procedures of choice in locoregional staging (intraosseous and extraosseous spread, skip metastases, growth plate and articular involvement)

Case report: Primary high grade surface osteosarcoma

  1. ance
  2. A rare variant of central high-grade OS, called pseudocystic OS has been described by Sundaram et al. 10 These lesions are purely osteolytic, intracompartmental and tend to expand the bone without any associated periosteal reaction or soft tissue mass (Fig. 4a,b). Simple bone cyst (SBC) and aneurysmal bone cyst (ABC) were the primary radiological diagnoses in all of their cases
  3. 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.
  4. g neoplasm which arises on the surface of the bone. It has a male predo
  5. Abstract Background Osteosarcoma (OS) arising from the surface of bone is far less common than its intramedullary counterpart. Although surface OSs share some radiographic and clinical features, th..

High grade surface osteosarcoma is a rare subtype of osteosarcoma arising on the surface of bone, accounting for only 8.9% of surface osteosarcomas at the study institution. METHODS. This study reviews 46 cases of high grade surface osteosarcoma, comprised of 13 cases from the Mayo Clinic files and 33 from the authors' files 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 High-grade surface osteosarcoma Prilozi, Odd. biol. med. nauki, XXVIII/2 (2007), 211‡222 213 Figure 1 - Plain film showed soft tissue mass on latero-posterior aspec

Osteosarcoma Radiology Review. 1. Osteosarcomas are malignant bone forming tumours and the second most common primary bone tumour after multiple myeloma . They account for ~20% of all primary bone tumours. 2. Osteosarcomas can be either primary or secondary, and these have differing demographics. Primary osteosarcoma - typically occurs in young. High-Grade Surface Osteosarcoma. It is the least common type of juxtacortical OS. The tumor is usually large and may reach up to 25cms. The radiological appearance includes malignant looking periosteal reaction, irregular shape dense ossification, cortical thickening and erosion

Pathology Outlines - Parosteal osteosarcoma

Parosteal osteosarcoma Radiology Reference Article

Osteosarcoma 22 High-grade surface Osteosarcoma 9 Low-grade Osteosarcoma 16 Multicentric Osteosarcoma 3 Parosteal Osteosarcoma 56 Dedifferentiated chondrosarcoma 43 Total 1,373 Classification system for Osteosarcoma developed at the Mayo Clinic.' disorders, particularly those that are aggressive in their behavior (eg, infection) These find- High-grade surface osteosarcoma is a rare subtype of ings fit the diagnosis of high-grade surface osteosarcoma. osteosarcoma arising on the surface of bone, accounting for In this case report, we described radiological and only 8.9% of surface osteosarcomas [6] A system commonly used to stage osteosarcoma is the MSTS system, also known as the Enneking system. It is based on 3 key pieces of information: The grade (G) of the tumor, which is a measure of how likely it is to grow and spread, based on how it looks under the microscope. Tumors are either low grade (G1) or high grade (G2)

The many faces of osteosarcoma

High-Grade-Histological identical to high grade/conventional/central variant differs only in geography, being found at any extraskeletal location in the body. History and Physical Symptoms of osteosarcoma may be present for a significant amount of time, sometimes weeks to months, before patients seek evaluation However, high-grade surface OS often involves the entire circumference of the cortex and is more likely to show medullary invasion. 12 Furthermore, the presence of a high histologic grade, identical to that of conventional OS, throughout the entire tumor is diagnostic of high-grade surface OS. Telangiectatic Osteosarcoma Durnali A, Alkis N, Cangur S, et al. Prognostic factors for teenage and adult patients with high-grade osteosarcoma: an analysis of 240 patients.  Med Oncol . 2013;30(3):624. doi: 10.1007/s12032-013-0624-6  PubMed Google Scholar Cros The prognosis for the peniosteal osteosarcoma is worse than that for the parosteal tumor but better than for the high-grade surface osteosarcoma. The peniosteal osteosancoma is often diaphyseal and frequently found on the tibia. 40.20, 40.352 Bones, radiography, 40.11 Fractures, 40.41 State-of-art reviews Radiology Abbreviation: A surface. The high grade surface osteosarcoma (OSAG), representing less than 1% of all osteosarcomas, has clinical features, radiological and pathological own, relevant to treatment and prognosis

1. Introduction. Osteosarcoma (OGS) is the most common primary bone tumor in children and adolescents (4.4 cases per 1 million persons annually). 1-5 The World Health Organization currently classifies OGS into conventional, telangiectatic, small cell, low-grade central, secondary, periosteal, high-grade surface, and parosteal types. 1,2 Parosteal OGS is rare, but is the most common. Clinical Radiology (1995) 50, 194-197 Case Report: Primary High Grade Surface Osteosarcoma H. CHEUNG, R. L. K. LAU* and S. Y. C. HSUt Departments of Radiology, *Pathology and tOrthopaedics, Princess Margaret Hospital, Kowloon, Hong Kong Three types of osteogenic sarcoma may arise in the juxtacortical region, occurring predominantly on the. Occasionally osteosarcoma of quite high histologic grade can produce deceptively innocent radiographic defects with sharp or even sclerotic margins. In very rare instances, osteosarcoma can originate within the epiphysis (epiphyseal osteosarcoma) and may be mistaken on radiographs for chondroblastoma or clear-cell chondrosarcoma 205 (see Figs. High-Grade Surface Osteosarcoma is a type of surface osteosarcoma (one that is present on the surface of the bone). It is the most infrequent type of surface osteosarcoma. The long bones of the body (typically the thigh bones) are most commonly affected by this malignant tumor. The exact cause of the condition is unknown and presently, it is.

A review of imaging of surface sarcomas of bone SpringerLin

High-grade intramedullary osteosarcomas constitute 85 % of all osteosarcoma causes. They commonly involve metaphyses of long bones where the vascularization and growth potential is exceptional. Distal femoral and proximal tibial lesions, where most of the skeletal growth is processed, constitute 50-60 % of all conventional osteosarcoma cases surface tumors, and recognises a number of subtypes within each group [1]. OS frequently originate in the metaphysis of the distal femu r, proximal tibia and proximal humerus. OSs are subdivided into the classic form (75%) and osteosarcoma variants (25%) [2, 3 & 4]. Th This study aims to report a rare paediatric case of low-grade surface osteosarcoma of the temporal bone. Materials and methods used: A literature review was performed to better understand paediatric osteosarcomas of the head and neck region, to optimize their investigation, to describe their histopathological and radiological characteristics. A malignant tumor in which the cells synthesize bone The most common primary malignant solid tumor of bone (plasma cell myeloma is actually the most common primary bone tumor but it's not a solid tumor) (Cancer Treat Res 2009;152:3) There are many types of osteosarcoma that differ based on the tumor's location (within the bone or on the surface of the bone) and the grade of the tumor (low. rare tumor of mesenchymal origin characterized by the production of osteoid (immature bone) by malignant cells 1,2; most common primary sarcoma of bone in children and adolescents (represents about 35% of all primary bone cancers) 1,2,3 most commonly affected bones are metaphyseal regions of long bones, including femur in about 40%, tibia in about 20%, humerus in about 10%, and pelvis in about.

(Radiology) Tests9. Biopsy The results of imaging tests might strongly suggest that a person has osteosarcoma (or some other type of bone cancer), but a biopsy (removing some of the tumor for viewin Osteosarcoma arising from cortical surface is classified into parosteal, periosteal and high-grade surface osteosarcoma Conventional high grade sarcoma, sclerotic type. Discussion. The experience of FNA of osteosarcoma is mainly with conventional high-grade intramedullary sarcoma and to the rare high-grade surface osteosarcoma. Smears usually contain dissociated neoplastic cells and cell clusters classified into 3 histologic subtypes: intramedullary, surface, and extraskeletal; high-grade intramedullary osteosarcoma (conventional/classic osteosarcoma) is a spindle cell tumor that produces osteoid or immature bone. reported to account for almost 80% of osteosarcomas; most common sites include metaphyseal region of distal femur and. At the dawn of the third millennium, cancer has become the bane of twenty-first century man, and remains a predominant p.. Pediatr Blood Cancer 2010;54:526-531 Noninvasive Imaging Surrogate of Angiogenesis in Osteosarcoma Jyoti Bajpai, MD,1 Shivanand Gamanagatti, MD,2 Mehar C. Sharma, MD,3 Rakesh Kumar, MD,4 Sreenivas Vishnubhatla, PhD,5 Shah Alam Khan, MS,6 Shishir Rastogi, MS,6 Arun Malhotra, MD,4 and Sameer Bakhshi, MD1* Purpose

A high grade chondrosarcoma must be considered in the differential diagnosis. A surface osteosarcoma could be considered in the differential diagnosis. by Theodore Miller March 2008 Radiology, 246, 662-674 Bonetumor.org. by Henri de Groot Parosteal sarcoma (pdf). 15. Sonneland P R, Unni K K. Case report 258. Diagnosis: high-grade 'surface' osteosarcoma arising from femoral shaft. Skel Radiol 1984; 11: 77d80. 16. Wold L E, Unni K K, Beabout J W et al. Dedifferentiated parosteal osteosarcoma. J Bone Jt Surg 1984; 66: 53d59. 17. Wold L E, Unni K K, Beabout J W et al. High-grade surface osteosarcomas Based on WHO definitions, juxta-cortical osteosarcomas include all surface osteosarcomas-parosteal, periosteal and high-grade surface osteosarcoma. Periosteal osteosarcomas arise from the inner, germinative periosteal layer (Fig. 15 ) whereas parosteal osteosarcomas arise from the outer, fibrous layer of the periosteum (Fig 14 )

Osteosarcoma - OrthoInfo - AAOS

From August 1986 to December 1994, 112 patients with high-grade osteosarcoma underwent preoperative chemotherapy, limb-sparing resection, reconstruction with a massive allograft, and postoperative chemotherapy. There were 107 patients with Enneking Stage II lesions and five with metastatic disease (Enneking Stage III) at presentation Current Combined Treatment of High-Grade Osteosarcomas. March 31, 1995. Timothy A. Damron, MD , Douglas J. Pritchard, MD. Oncology, ONCOLOGY Vol 9 No 4, Volume 9, Issue 4. The evaluation and treatment of osteosarcoma have evolved considerably over the past 2 decades, with corresponding dramatic improvements in prognosis Primary Osteosarcoma is subdivided into: 1.INTRAMEDULLARY (95%) A. HIGH GRADE ( MOST COMMON)-CONVENTIONAL OSTEOSARCOMA. B. LOW GRADE (rare) 2. SURFACE OSTEOSARCOMA (most commonly low grade) • PAROSTEAL (low grade) • PERIOSTEAL (low grade) • HIGH GRADE SURFACE (least common)- HIGH GRADE AS CONVENTIONAL OGS High-Grade surface osteosarcoma is the least common form of surface osteosarcoma and it is completely high grade histologically. High-grade surface osteosarcoma is believed to have the same prognosis as conventional osteosarcoma; however, Radiology. 1990; 175(3):. For high-grade tumors such as osteosarcoma, a skip lesion portends a poor prognosis. Determining the effect on survival of multifocal low-grade lesions, such as low-grade chondrosarcomas or low-grade vascular tumors, has proven to be more difficult . This AJCC staging system does not apply to primary malignant lymphoma of bone or multiple.

Imaging Characteristics of Primary Osteosarcoma

Osteosarcoma is a mesenchymally derived high-grade bone sarcoma. It is the most common malignant tumour of bone in childhood, before chondrosarcoma and Ewing sarcoma. It occurs most often in adolescents and young adults (10-25 years) with a predominance in males. The pathogenesis and aetiology of this disease remain obscure Osteosarcoma data were available for 10,922 high-grade conventional, 647 parosteal, 247 Paget's, 93 small cell, 33 periosteal, 11 low-grade intraosseous, and eight high-grade surface lesions. Since the osteosarcoma codes changed in 2001, the osteosarcoma histologic data for 2001 to 2003 were analyzed separately to provide a relative frequency. In the usual high‐grade surface osteosarcoma, there is no low‐grade parosteal component present, but only a osteoblastic, fibroblastic, or chondroblastic osteosarcoma, all of which are indistinguishable histologically from a classic central osteosarcoma. importance of lytic changes and fluid cavities at imaging, Skeletal Radiology, 10. Paula R.L. Sonneland, M.D., c/o Section of Publications, Mayo Clinic, Rochester, MN 55905, USA 9 1984 International Skeletal Society P.R.L. Sonnelandand K.K. Unni: Case Report 258 Diagnosis: High-Grade Surface Osteosareoma Arising from the Femoral Shaft Parosteal osteosarcoma and periosteal osteosarcoma must necessarily be included in the.

Imaging of Periosteal Osteosarcoma: Radiologic-Pathologic

High-grade conventional intramedullary osteosarcoma is the most common subtype. It is a biologically complex and aggressive tumor with a propensity to involve the growing metaphysis of the extremity bones, usually adjacent to the physes with the greatest growth (lower femur, upper tibia, and the upper end of the humerus) lateral x-ray of high-grade surface osteosarcoma on the right distal femur; d) Parosteal osteosarcoma showing parallel osteoid trabeculae embedded in fibroblastic stroma (HE, x100). Periosteal osteosarcoma constitutes 1 to 2% of all osteosarcoma cases and is usually more aggressive than the parosteal variant

The topic Conventional High Grade Osteogenic Sarcoma you are seeking is a synonym, or alternative name, or is closely related to the medical condition Conventional Osteosarcoma. Quick Summary: Osteosarcoma forms a class of highly-cancerous, high-mortality, bone tumor Parosteal osteosarcoma is a low-grade tumor microscopically. Approximately 80% of tumors are grade 1 and 20% are grade 2.2 Accordingly, it has a well differentiated spindle cell stroma, minimal atypia and a low mitotic rate. The tumor originates from the outer fibrous layer of periosteum. The fibroblastic stroma may have foci of trabecular bone. Western Infirmary, Glasgow Osteosarcomas arising on the surface of long bones are now classified into parosteal, periosteal, and high grade surface osteosarcomas, with important prognostic implications. The diagnosis, both radiological and histological, is fraught with difficulties however Follow up and Prognosis Signs of recurrence, metastasis and treatment related complications Physical examination,radiographs of the primary site, serial chest imaging,bone scans and laboratory examinations 50 % cases with high grade osteosarcoma have some type of relapse in 5 months If recurrence is detected, additional surgery (radical.

Conventional osteosarcoma with periosteal spread; High grade surface osteosarcomas: may be juxtacortical but different histology Myositis ossificans: orderly maturation, not attached to underlying bone; more active histologically Osteochondroma: tumor continuous with bone, fatty or hematopoietic marrow presen Intracortical osteosarcoma is very rare high-grade osteosarcoma that from histological point of view is osteoid or maybe bone formation. It is treated like conventional osteosarcoma (Figures 5,6). Multifocal osteosarcoma is unusual, affect children, young adults. It is a high-grade sarcoma, very aggressive, without escape in terms of surviving The typical 11 patients, 1 had co-existing low- Differential diagnosis consider- radiographic features are those of a grade parosteal osteosarcoma and ation includes parosteal, periosteal, rounded, lytic intracortical lesion high-grade dedifferentiation when and high-grade surface osteosarco- less than 4 cm in maximum dimen- first seen

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