The radiological appearances of telangiectatic osteosarcoma

Vanel, D.; Tcheng, S.; Contesso, G.; Zafrani, B; Kalifa, Chantal; Dubousset, Jean; Kron, Philipp

doi:10.1007/bf00356952

Cited by 35 publications

(17 citation statements)

References 3 publications

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“…The 43% rate of pathologic fracture among our patients with TOS was consistent with previous findings of significantly higher rates of this complication in TOS (17-32%) than in conventional OS (6-13%). [2][3][4]7,9,18,29,30 Our retrospective review of the diagnostic imaging studies may have led to a higher rate of detection of pathologic fracture in our study than in previous studies. A very high rate of pathologic fracture (61%) also was noted in a recent retrospective review of radiologic features in 36 patients with TOS.…”

Section: Discussionmentioning

confidence: 58%

“…There are many reports in the literature about patients with TOS that was diagnosed incorrectly; and it is important to note that delaying the correct diagnosis and initiation of proper therapy may have a negative effect on survival. [8][9][10][11] An aneurysmal bone cyst in particular is almost indistinguishable from TOS on radiographs, but the correct diagnosis can be established by careful microscopic examination. [26][27][28] Accordingly, the radiologic and pathologic inclusion criteria used by us and others to make the diagnosis of TOS seem most appropriate.…”

Section: Discussionmentioning

confidence: 99%

“…6 One possible explanation for the high rate of pathologic fractures in patients with TOS is the extensively lytic and cystic nature of the tumor, which may make the bone more prone to fracture. 3,9,10 One purpose of our retrospective review was to uncover any potential risk factors that hold predictive clinical significance for this OS subtype. In agreement with results of previous studies, the results of our univariate analyses of survival did not reveal statistically significant differences among most variables analyzed (eg, age, sex, race, and primary tumor site).…”

Section: Discussionmentioning

confidence: 99%

“…7 Many case reports have described misdiagnosed TOS as an aneurysmal bone cyst, and this misdiagnosis often results in a delay in diagnosis and potentially affects the outcome. [8][9][10][11] Although TOS displays radiographic and histopathologic findings that are distinct from those of other OS variants, the clinical significance of the TOS variant has been unclear; and some have questioned whether its significance is purely academic, because it appears to have no prognostic clinical implications. 1 The prognosis for patients with TOS has been debated in the literature for many decades.…”

mentioning

confidence: 99%

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Telangiectatic osteosarcoma: The St. Jude Children's Research Hospital's experience

Weiss

Khoury

Hoffer

et al. 2007

Cancer

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BACKGROUND. Telangiectatic osteosarcoma (TOS) isRESULTS. Among 323 patients with OS, 22 patients (6.8%) had TOS. Two additional patients who were treated in Chile on a recent OS trial were included. The median age at diagnosis of the 24 patients was 15.7 years. Four patients (17%) had metastatic disease, and 9 of 21 patients (43%) had pathologic fractures. Only 5 patients (who were treated after 1994) underwent limb-salvage surgery.Estimates of 5-year event-free survival (58.3% AE 11.9%) and overall survival (66.8% AE 11.6%) were similar to those for patients with other OS subtypes (P ! .85). The absence of local disease progression and chemotherapy with !3 agents that were active against OS were correlated with improved outcome (P .005).The presence of a pathologic fracture was not associated with surgery type or patient outcome.CONCLUSIONS. TOS was associated with a high rate of pathologic fracture. With multimodality therapy, the outcome of patients with TOS was similar to that of patients with other high-grade OS subtypes. The absence of local disease progression and chemotherapy with !3 active agents were associated with a favorable outcome.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Telangiectatic osteosarcoma: The St. Jude Children's Research Hospital's experience

Weiss

Khoury

Hoffer

et al. 2007

Cancer

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“…In most cases of aneurysmal bone cyst, a careful study of the radiographs will usually indicate the benign nature of the lesion: a sharply demarcated expansile, lytic lesion with a thin, although usually uninterrupted cortical margin. A clearly malignant appearance, such as a permeating pattern of cortical and trabecular bone destruction or a periosteal reaction with Codman's triangles, is exceptional for aneurysmal bone cyst [10]. In our series, one patient had telangiectatic osteosarcoma located in the left distal femur.…”

Section: Discussionmentioning

confidence: 94%

Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

et al. 2006

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The purpose of this study was to determine the prevalence, extension and signal characteristics of fluid-fluid levels in a large series of 700 bone and 700 soft tissue tumors. Out of a multi-institutional database, MRI of 700 consecutive patients with a bone tumor and MRI of 700 consecutive patients with a soft tissue neoplasm were retrospectively reviewed for the presence of fluid-fluid levels. Extension (single, multiple and proportion of the lesion occupied by fluid-fluid levels) and signal characteristics on magnetic resonance imaging of fluid-fluid levels were determined. In all patients, pathologic correlation was available. Of 700 patients with a bone tumor, 19 (10 male and 9 female; mean age, 29 years) presented with a fluid-fluid level (prevalence 2.7%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included aneurysmal bone cyst (ten cases), fibrous dysplasia (two cases), osteoblastoma (one case), simple bone cyst (one case), telangiectatic osteosarcoma (one case), "brown tumor" (one case), chondroblastoma (one case) and giant cell tumor (two cases). Of 700 patients with a soft tissue tumor, 20 (9 males and 11 females; mean age, 34 years) presented with a fluid-fluid level (prevalence 2.9%). Multiple fluid-fluid levels occupying at least one half of the total volume of the lesion were found in the majority of patients. Diagnoses included cavernous hemangioma (12 cases), synovial sarcoma (3 cases), angiosarcoma (1 case), aneurysmal bone cyst of soft tissue (1 case), myxofibrosarcoma (1 case) and high-grade sarcoma "not otherwise specified" (2 cases). In our series, the largest reported in the literature to the best of our knowledge, the presence of fluid-fluid levels is a rare finding with a prevalence of 2.7 and 2.9% in bone and soft tissue tumors, respectively. Fluid-fluid levels remain a non-specific finding and can occur in a wide range of bone and soft tissue tumors, both benign and malignant. Therefore, they cannot be considered diagnostic of any particular type of tumor, and the diagnosis should be made on the basis of other radiological and clinical findings.

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Malignant transformation of aneurysmal bone cyst, with an analysis of the literature

Kyriakos

Hardy

1991

Cancer

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An 11‐year‐old girl had a lytic, benign‐appearing, expansive lesion of the distal tibia radiologically interpreted as an aneurysmal bone cyst (ABC). Tissue from two extensive curettage procedures was also histologically diagnosed as ABC. Approximately 50 months after the onset of symptoms, and 28 months after her last curettage, a highly pleomorphic osteosarcoma developed. The patient had not received prior radiation therapy. The cases in the literature of possible malignant transformation of ABC are reviewed. The authors separate their case from telangiectatic osteosarcoma, and from “ aneurysmal bone cyst‐like osteosarcoma”.

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The radiological appearances of telangiectatic osteosarcoma

Cited by 35 publications

References 3 publications

Telangiectatic osteosarcoma: The St. Jude Children's Research Hospital's experience

Telangiectatic osteosarcoma: The St. Jude Children's Research Hospital's experience

Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors

Malignant transformation of aneurysmal bone cyst, with an analysis of the literature

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