title: Periosteal osteosarcoma of the femur with bone marrow involvement: a case report.
abstract: Periosteal osteosarcoma is an exceedingly rare type of chondroblastic osteosarcoma, showing rather better prognosis, and secondary bone marrow involvement is unusual. A case of a 22 year old male with periosteal osteosarcoma of the right femur with an associated bone marrow lesion is presented. The juxtacortical tumor, 16 x 11 x 9 cm, was located on the bone cortex of the upper diaphysis and extended into the surrounding soft tissues. A minimal bone marrow lesion was present, although the bone cortex was quite intact. Microscopically, the tumor consisted exclusively of atypical chondroblastic cells with a small osteoblastic area. The bone marrow lesion, interestingly, contained both multiple nodules of well-differentiated chondrosarcomatous components and a few demarcated foci of atypical spindle cells producing a fine osteoid matrix. It was reasonable to conclude, therefore, that this tumor was a periosteal osteosarcoma with an unusual secondary bone marrow lesion rather than a conventional (central) chondroblastic osteosarcoma with soft tissue invasion. The patient's good prognosis with no tumor recurrence or metastasis during more than 7 years follow-up after surgery supports this conclusion.
authors.affiliation: Department of Pathology, Kochi Medical School, Nankoku, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Sonobe
authors.forename: J
authors.initials: J
authors.lastname: Iwata
authors.forename: M
authors.initials: M
authors.lastname: Furihata
authors.forename: Y
authors.initials: Y
authors.lastname: Ohtsuki
authors.forename: H
authors.initials: H
authors.lastname: Mizobuchi
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D001853:Bone Marrow / Q000473:pathology*; D005266:Femoral Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male; D018217:Osteosarcoma, Juxtacortical / Q000473:pathology*