Parosteal osteosarcoma: a treatment-oriented study.
Parosteal osteosarcoma carries the best prognosis of all forms of osteogenic sarcoma. In our series of cases, adequate resection of low- and moderate-grade lesions has resulted in long-term survival without any evidence of residual disease. Small lesions of less than 5 cm diameter and low grade cellular atypism are treatable by an en bloc resection with 2.5 cm margins of normal bone. Larger lesions, of Grade I-II malignancy, are more successfully treated by a two-stage resection spaced six months apart. Recurrences of low-grade tumors are also successfully treated by this method. Grade III lesions, and all those with intramedullary involvement, should be treated by measures appropriate for other types of high-grade osteogenic sarcoma. Special problems encountered in resection surgery are managed by prevention of pathologic fracture, bone grafts, avoidance or repair of major neurovascular structures, and preservation of joint function.
D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000473:pathology / Q000601:surgery*; D011379:Prognosis