Pediatric Osteosarcoma: Correlation of Imaging Findings with                     Histopathologic Features, Treatment, and Outcome

Nguyen, Jie C.; Baghdadi, Soroush; Pogoriler, Jennifer; Guariento, Andressa; Rajapakse, Chamith S.; Arkader, Alexandre

doi:10.1148/rg.210171

Cited by 21 publications

(6 citation statements)

References 73 publications

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“…LMSB occurs mostly in the long bones of the lower limbs and should be differentiated from other common bone tumors after the exclusion of metastases ( 7 ). LMSB commonly occurs in the same locations as osteosarcoma with more obvious bone destruction and periosteum reactions observed using radiography and CT, which are specific manifestations ( 20 ). However, the periosteal reactions of LMSB are not obvious.…”

Section: Discussionmentioning

confidence: 99%

“…Myelomas may also present with lytic bone destruction, though osteoporosis can be observed on radiography and CT, and a myeloma includes multiple lesions with irregular shapes ( 21 ). LMSB, osteosarcoma, and myeloma appear as low-intensity lesions on T1-weighted images and high-intensity lesions T2-weighted images on MRI ( 7 , 20 , 21 ). Therefore, the specificity of the imaging results of LMSB is relatively low, and the diagnosis is dependent on pathological examination ( 8 , 22 ).…”

Section: Discussionmentioning

confidence: 99%

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Case report and literature review: Primary leiomyosarcoma of the bone in the trochanteric region of the femur

Li²,

Cao³

et al. 2023

Front. Surg.

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BackgroundPrimary leiomyosarcoma of the bone (LMSB) is an extremely rare, invasive, and highly destructive primary osteosarcoma with limited treatment options and poor prognosis. Only a few case reports of LMSB have been described because of its rarity. Therefore, clinicians have a limited understanding of its diagnosis, treatment, and prognosis, and the final diagnosis depends on histopathological findings. In this report, we describe a rare case of primary LMSB in the trochanteric region of the femur. Reporting this case may increase the dissemination and understanding of information regarding LMSB and provide a reference for the diagnosis and treatment of similar cases.Case presentationA 63-year-old woman presented with pain and limited movement of the left hip, which had lasted for 3 months, with no history of trauma or illness. Plain radiography and computed tomography revealed a solitary osteolytic lesion in the trochanteric area of the left femur with focal cortical destruction. Magnetic resonance imaging findings suggested invasion of the lesion into the bone cortex, forming a soft tissue mass, although no distant positive findings were observed on a whole-body bone scan. A bone tumor puncture biopsy was performed to obtain a final diagnosis, and histopathological evaluation revealed left femoral intertrochanteric leiomyosarcoma, classified as G1T2M0 and staged as IB (extracompartmental low-grade malignant) according to the Enneking staging system. Thus, we performed extensive debridement and left hip arthroplasty. Postoperative chemotherapy was administered, and the patient was followed up for 4 years. Four years later, the patient's left hip pain had resolved, joint activity was good, and no signs of recurrence or distant metastasis of the bone tumor were noted.ConclusionFor proximal femoral Enneking stage IB LMSB, extensive tumor resection combined with tumor prosthesis replacement may be an effective treatment method to prolong the patient's lifespan and to restore joint function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Case report and literature review: Primary leiomyosarcoma of the bone in the trochanteric region of the femur

Li²,

Cao³

et al. 2023

Front. Surg.

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“…They show very high signal in relation to the lesion, but also because of the surrounding bone edema and the presence of hematopoietic bone marrow, although they are very useful to determine soft tissue involvement. 51 After gadolinium contrast administration, a heterogeneous pattern of enhancement is characteristic due to the presence of cystic and necrotic areas within the tumor.…”

Section: Osteosarcomamentioning

confidence: 99%

Neoplastic and Non-neoplastic Bone Lesions of the Knee

Expósito,

Martel,

Alvarez de Sierra

et al. 2024

Semin Musculoskelet Radiol

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Numerous anatomical variants are described around the knee, many of which look like bony lesions, so it is important to know them to avoid unnecessary complementary tests and inadequate management. Likewise, several alterations in relation to normal development can also simulate bone lesions.However, numerous pathologic processes frequently affect the knee, including traumatic, inflammatory, infectious, and tumor pathology. Many of these entities show typical radiologic features that facilitate their diagnosis. In other cases, a correct differential diagnosis is necessary for proper clinical management.Despite the availability of increasingly advanced imaging techniques, plain radiography is still the technique of choice in the initial study of many of these pathologies. This article reviews the radiologic characteristics of tumor and nontumor lesions that may appear around the knee to make a correct diagnosis and avoid unnecessary complementary radiologic examinations and inadequate clinical management.

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“…(4,10,11) O osteossarcoma primário envolve o fêmur distal, a tíbia proximal e o úmero proximal em mais de 75% dos casos; nos demais casos, outros ossos longos e chatos são afetados. (12) O osteossarcoma pode apresentar metástase em praticamente qualquer sítio ou órgão, principalmente nos pulmões, mas às vezes nos ossos e linfonodos. No momento do diagnóstico, 18-30% dos pacientes com osteossarcoma apresentam doença metastática, e os pulmões são o sítio mais comumente afetado.…”

Section: Introductionunclassified

“…Primary osteosarcoma involves the distal femur, proximal tibia, and proximal humerus in more than 75% of cases, other long and flat bones being affected in the remaining cases. 12 Osteosarcoma can metastasize to virtually any site or organ, mostly to the lungs, but occasionally to bone and lymph nodes. At the time of diagnosis, 18-30% of patients with osteosarcoma have metastatic disease, the lungs being the most commonly affected site.…”

Section: Introductionmentioning

confidence: 99%

CT features of osteosarcoma lung metastasis: a retrospective study of 127 patients

et al. 2023

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Objective: Osteosarcoma lung metastases have a wide variety of CT presentations, representing a challenge for radiologists. Knowledge of atypical CT patterns of lung metastasis is important to differentiate it from benign lung disease and synchronous lung cancer, as well as to determine the extent of primary disease. The objective of this study was to analyze CT features of osteosarcoma lung metastasis before and during chemotherapy. Methods: Two radiologists independently reviewed chest CT images of 127 patients with histopathologically confirmed osteosarcoma treated between May 10, 2012 and November 13, 2020. The images were divided into two groups for analysis: images obtained before chemotherapy and images obtained during chemotherapy (initial CT examination). Results: Seventy-five patients were diagnosed with synchronous or metachronous lung metastases. The most common CT findings were nodules (in 95% of the patients), distributed bilaterally (in 86%), with no predominance regarding craniocaudal distribution (in 71%). Calcification was observed in 47%. Less common findings included intravascular lesions (in 16%), cavitation (in 7%), and the halo sign (in 5%). The primary tumor size was significantly greater (i.e., > 10 cm) in patients with lung metastasis. Conclusions: On CT scans, osteosarcoma lung metastases typically appear as bilateral solid nodules. However, they can have atypical presentations, with calcification being the most common. Knowledge of the typical and atypical CT features of osteosarcoma lung metastasis could play a key role in improving image interpretation in these cases.

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Pediatric Osteosarcoma: Correlation of Imaging Findings with Histopathologic Features, Treatment, and Outcome

Cited by 21 publications

References 73 publications

Case report and literature review: Primary leiomyosarcoma of the bone in the trochanteric region of the femur

Case report and literature review: Primary leiomyosarcoma of the bone in the trochanteric region of the femur

Neoplastic and Non-neoplastic Bone Lesions of the Knee

CT features of osteosarcoma lung metastasis: a retrospective study of 127 patients

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