Osteosarcoma Anatomic and Histologic Variants (original) (raw)
Related papers
Histopathology and Molecular Pathology of Bone and Extraskeletal Osteosarcomas
cdn.intechopen.com
Histopathology and Molecular Pathology of Bone and Extraskeletal Osteosarcomas 5 2. Pathologic features 2.1 Conventional osteosarcoma Conventional osteosarcoma, is solitary, arises in the medullary cavity of an otherwise normal bone, is of high grade and produces neoplastic bone with or without cartilaginous or fibroblastic components. The gross findings are variable depending on the amount of bone and other components present. It manifests as a large, metaphyseal, intramedullary and tangray-white, gritty mass. Tumours that are producing abundant mineralized bone are tangray and hard, whereas non-mineralized, cartilaginous components are glistening, gray, and may be mucinous if the matrix is myxoid, or more rubbery if hyaline in nature. It can be necrotic, hemorrhagic and cystic. Intramedullary involvement is often considerable and the tumour usually destroys the overlying cortex and forms an eccentric or circumferential soft tissue component that displaces the periosteum peripherally. In the proximal and distal portions of the tumour the raised periosteum deposits a reactive bone, known as Codman's triangle. In some cases, the tumour grows into the joint space, resulting in coating of the peripheral portions of the articular cartilage by the sarcoma. Solitary or multiple skip metastases appear as intramedullary nodules in the vicinity of or far from the main mass. Furthermore, not all osteosarcomas arise in a solitary fashion, as multiple sites may become apparent within a period of about 6 months (synchronous osteosarcoma), or multiple sites may be noted over a period longer than 6 months (metachronous osteosarcoma). Such multifocal osteosarcoma is decidedly rare, but when it occurs, it tends to be in patients, younger than 10 years. The diagnosis of osteosarcoma is based on the accurate identification of osteoid. Osteoid is unmineralized bone matrix that histologically appears as eosinophilic, dense, homogeneous, amorphous and curvilinear intercellular material, somewhat refractile. It must be distinguished from other eosinophilic extra-cellular materials such as fibrin and amyloid. Unequivocal discrimination between osteoid and non-osseous collagen may be difficult, or sometimes arbitrary (Fornasier, 1977). Non-osseous collagen tends to be linear, fibrillar and compresses between neoplastic cells. In contrast, osteoid is curvilinear with small nubs, arborisation and what appears to be abortive, lacunae formation. The thickness of the osteoid is highly variable with the 'thinnest' variant referred to as 'filigree', whereas osteoid seams are flat and thick. Osseous matrix has also the predisposition for appositional deposition upon previously existing normal bone trabeculae ('scaffolding'). Conventional osteosarcoma can produce varying amounts of cartilage and/or fibrous tissue. The algorithm is: identify the presence or absence of matrix, and if significant matrix is present, determine the matrix form and therefore subclassify into osteoblastic, chondroblastic, fibroblastic and mixed types, by virtue of the predominance of the neoplastic component.
Differential Diagnosis of Osteogenic Tumors in the Context of Osteosarcoma
Osteosarcoma – Diagnosis, Mechanisms, and Translational Developments [Working Title]
Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. Elevated AKP is an important prognostic factor in this malignancy.
Osteosarcoma: a comprehensive review
SICOT-J
Osteosarcoma (OS) is a relatively rare tumor of bone with a worldwide incidence of 3.4 cases per million people per year. For most of the twentieth century, five-year survival rates for classic OS were very low. In the 1970s, the introduction of adjuvant chemotherapy in the treatment of OS increased survival rates dramatically. The current article reviews the various types of OS and analyzes the clinical and histological features. We also examine historical and current literature to present a succinct review of methods for diagnosis and staging, as well as treatment, and we also discuss some of the future directions of treatment.
International Journal of Advanced Community Medicine , 2022
Osteosarcoma (OS) is a primary malignant bone tumor with a worldwide incidence. OS is a rare sarcoma that has the histological findings of osteoid production in association with malignant mesenchymal cells. Osteosarcoma is the eighth-most common form of childhood cancer. The most common site of origin is the metaphyseal region of tubular long bones, with 42% occurring in the femur, followed by the tibia, and the humerus. We reported a case of osteosarcoma of the right tibia in a 12-year-old patient.
Osteosarcoma: a multidisciplinary approach to diagnosis and treatment
American family physician, 2002
The treatment of osteosarcoma requires a multidisciplinary approach involving the family physician, orthopedic oncologist, medical oncologist, radiologist and pathologist. Osteosarcoma is a mesenchymally derived, high-grade bone sarcoma. It is the third most common malignancy in children and adolescents. The most frequent sites of origin are the distal femur, proximal tibia and proximal humerus. Patients typically present with pain, swelling, localized enlargement of the extremity and, occasionally, pathologic fracture. Most patients present with localized disease. Radiographs commonly demonstrate a mixed sclerotic and lytic lesion arising in the metaphyseal region of the involved bone. Computed tomography and bone scanning are recommended to detect pulmonary and bone metastases, respectively. Before 1970, osteosarcomas were treated with amputation. Survival was poor: 80 percent of patients died from metastatic disease. With the development of induction and adjuvant chemotherapy pro...
Review of Osteosarcoma and Current Management
Rheumatology and Therapy, 2016
Osteosarcoma is the most common primary malignancy of bone in children and young adults. This tumor has a very heterogeneous genetic profile and lacks any consistent unifying event that leads to the pathogenesis of osteosarcoma. In this review, some of the important genetic events involved in osteosarcoma will be highlighted. Additionally, the clinical diagnosis of osteosarcoma will be discussed, as well as contemporary chemotherapeutic and surgical management of this tumor. Finally, the review will discuss some of the novel approaches to treating this disease.