Osteosarcoma: Diagnostic dilemmas in histopathology and prognostic factors

Abstract

Osteosarcoma (OS), the commonest malignancy of osteoarticular origin, is a very aggressive neoplasm. Divergent histologic differentiation is common in OS; hence triple diagnostic approach is essential in all cases. 20% cases are atypical owing to lack of concurrence among clinicoradiologic and pathologic features necessitating resampling. Recognition of specific anatomic and histologic variants is essential in view of better outcome. Traditional prognostic factors of OS do stratify patients for short term outcome, but often fail to predict their long term outcome. Considering the negligible improvement in the patient outcome during the last 20 years, search for novel prognostic factors is in progress like ezrin vascular endothelial growth factor, chemokine receptors, dysregulation of various micro ribonucleic acid are potentially promising. Their utility needs to be validated by long term followup studies before they are incorporated in routine clinical practice.

Establishment of Four New Human Primary Cell Cultures from Chemo-Naïve Italian Osteosarcoma Patients

“…3). OS3 negligible response to 1a, 25-Dihydroxyvitamin D 3 at the 3 rd generation could be attributed to the OS subtype, the small cell one, that was characterized by a minimal osteoid production (Wadhwa, 2014), while, the strong down-regulation of ALPP activity after 1a, 25-Dihydroxyvitamin D 3 treatment observed at the 10 th generation could be ascribed to a low differentiation stage of OS3 which is congruent with the inhibition of the ALPP expression caused by 1a, 25-Dihydroxyvitamin D 3 addiction in early stages of HOb cultures (Bikle, 2012). However, this represents, to our knowledge, the first evidence of ALPP strong decrease 1a, 25-Dihydroxyvitamin D 3 -induced in OS cells.…”

Radiological review of skull lesions

“…Multiple histological subtypes of osteosarcoma have been described which comprise the conventional or high-grade osteosarcoma, low-grade osteosarcoma, telangiectatic osteosarcoma, periosteal and parosteal osteosarcoma. Many lesions also contain other elements, such as fibroid or chondroid components [ 45 ].…”

A population-based propensity-matched study of regional dissections in patients with metastatic osteosarcoma

“…Osteosarcoma is the most common primary malignant bone tumour in children and adolescents [1]. It is characterized by rapid progression, early pulmonary metastasis, poor prognosis and recurrence [2][3][4].…”