Periosteal Osteosarcoma: A Review of 17 Cases with Mean Follow‐upof 52 Months

Abstract

Purpose: Periosteal osteosarcomas are rare cartilage-rich bone tumours characterized by a juxtacortical eccentric position and are normally regarded oncologically as of intermediate to high grade.Their low incidence is mirrored by a small number of reported cases in the world literature. While there is general agreement that wide surgical excision is required, there is a paucity of evidence regarding adjuvant therapy. Previous reports have not indicated any consistent approach to this to allow appraisal. Patients and methods:We report 17 cases treated at our centre over 16 years. Our policy was to use chemotherapy when the tumour showed any features of high grade. Results: To date, no deaths have resulted from recurrence or metastasis of the tumour although there have been two deaths from other causes. Discussion: Comparison of survival with existing studies is made to draw conclusions regarding future treatment of this condition in terms of surgical and adjuvant approaches.

Intentional marginal resection of periosteal osteosarcoma in combination with neoadjuvant chemotherapy: A report of two cases and a review of the literature

“…However, a review of 17 cases with a mean follow-up time of 52 months showed the encouraging effects of chemotherapy, with results indicating 100% metastasis-free survival among PO cases (3). Furthermore, the outcome indicated that it may be too prudent for the decision to use chemotherapy to be only shared with patients with high-grade PO, suggesting that chemotherapy may be routinely utilized in PO of intermediate grade (1,3,16). In the present study, chemotherapy was administered in two intermediate-grade PO patients who proved to be good responders to the treatment, and who experienced disease-free survival times of 37 and 108 months, respectively, at last follow-up.…”

“…Therefore, a wide excision is considered mandatory to achieve the complete removal of a tumor (1,19,20). However, a wide excision often necessitates removal of functional structures, resulting in prolonged surgery time and compromised limb function (3,8,(20)(21)(22). Furthermore, recurrences and metastases are not rare in patients undergoing a wide excision of a tumor (1,19).…”

“…Compared with other osteosarcoma subtypes, PO has a low propensity to metastasize, and it is histologically an intermediate-grade tumor. The therapeutic regimen for PO is controversial (4-6), although there is a widely accepted consensus that a wide surgical excision is the mainstay of treatment for PO (3)(4)(5)(6). However, post-operative limb function is usually compromised by a wide excision as the procedure results in a considerable wound, which leads to difficulties regarding reconstruction and rehabilitation (5,6).…”

“…PO represents <2% of all osteosarcomas (1) and this low incidence is mirrored by the lack of large case series. The diagnosis of PO should preclude high-grade surface sarcoma and parosteal sarcoma (2,3). Compared with other osteosarcoma subtypes, PO has a low propensity to metastasize, and it is histologically an intermediate-grade tumor.…”

Ekstraaksiyel Beyin Tumorleri

“…Perikraniyel veya dış kalvaryal yüzeyden gelişebilir. Diferansiye olmadığı sürece intrakraniyel uzanım izlenmez [201,202]. Kafa tabanından çok kubbede daha sık görülür [203].…”