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- Title
Diagnosis and treatment of low-grade osteosarcoma: experience with nine cases.
- Authors
Hayashi, Katsuhiro; Tsuchiya, Hiroyuki; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Takeuchi, Akihiko; Kimura, Hiroaki; Miwa, Shinji; Inatani, Hiroyuki; Okamoto, Hideki; Yamada, Satoshi; Ikeda, Hiroko; Sawada-Kitamura, Seiko; Nojima, Takayuki; Ooi, Akishi; Otsuka, Takanobu
- Abstract
Background: Low-grade osteosarcoma, including low-grade central osteosarcoma and parosteal osteosarcoma, is an extremely rare variant, and the diagnosis is occasionally difficult. In this article we present cases of low-grade osteosarcomas that should be reviewed by a clinical oncologist. Patients and methods: Nine cases of histologically diagnosed Broder grade 1 osteosarcoma were retrospectively reviewed. The pathological diagnoses included parosteal osteosarcoma, low-grade central osteosarcoma, and low-grade chondroblastic osteosarcoma in four, four, and one cases, respectively. Results: Duration from initial surgical intervention including biopsy to final diagnosis as low-grade osteosarcoma was a mean of 9.4 months. The initial benign diagnoses on biopsy specimens included fibrous dysplasia in three cases, chondroblastoma in one case, and a giant cell tumor in one case. The average number of histological examinations was 1.8. Low-grade osteosarcomas are well suited for biological reconstruction: seven cases were reconstructed by frozen autografts, distraction osteogenesis, or vascularized bone grafts. Conclusion: Low-grade osteosarcomas can be misdiagnosed as benign lesions, especially fibrous dysplasia. If the diagnosis of a low-grade osteosarcoma is not established on the basis of radiologic findings, care should be exercised, even when a biopsy suggests a benign lesion. Low-grade osteosarcomas should be treated with wide excision, even after an intralesional excision. Biological reconstruction might be a better option for low-grade osteosarcomas.
- Subjects
OSTEOSARCOMA; COHORT analysis; CLINICAL trials; ONCOLOGISTS; FIBROUS dysplasia of bone; DIAGNOSIS; THERAPEUTICS
- Publication
International Journal of Clinical Oncology, 2014, Vol 19, Issue 4, p731
- ISSN
1341-9625
- Publication type
Article
- DOI
10.1007/s10147-013-0592-z