title: Clinical management of a challenging malignancy, osteoblastoma-like osteosarcoma: a report of four cases and a review of the literature.
abstract: Osteoblastoma-like osteosarcoma, a rare form of osteosarcoma, is a malignant lesion associated with risks of both local recurrence and distant metastasis. The differential diagnosis of osteoblastoma-like osteosarcoma from osteoblastoma and aggressive osteoblastoma remains controversial and challenging. Previous studies suggest that these three types of tumor are distinct entities. However, working out a precise diagnosis may not always be possible immediately on the basis of initial clinical, radiological, and histopathological features. On the other hand, the importance of a correct diagnosis cannot be overemphasized since the treatment strategies change dramatically according to the nature of the lesion. In all of our cases, initial Tru-Cut biopsies revealed osteoblastic features with minimal atypia, but further biopsies confirmed malignancy. A high index of suspicion and considerable experience are prerequisites for accurate diagnosis in case of clinicopathological and radiological discordance.
authors: Department of Orthopaedics and Traumatology, Maslak Acıbadem Hospital, Istanbul.
authors: Harzem
authors: H
authors: Ozger
authors: Department of Orthopaedics and Traumatology, Maslak Acıbadem Hospital, Istanbul.
authors: Bugra
authors: B
authors: Alpan
authors: Department of Orthopaedics and Traumatology, Bingöl State Hospital, Bingöl.
authors: Mehmet Salih
authors: MS
authors: Söylemez
authors: Department of Orthopaedics and Traumatology, Faculty of Medicine, Istanbul Medeniyet University.
authors: Korhan
authors: K
authors: Ozkan
authors: Department of Orthopaedics and Traumatology.
authors: Ahmet
authors: A
authors: Salduz
authors: Department of Pathology, Faculty of Medicine, Istanbul University.
authors: Bilge
authors: B
authors: Bilgic
authors: Department of Radiology, Maslak Acıbadem Hospital, Istanbul, Turkey.
authors: Basak Kumbasar
authors: BK
authors: Sirin
keywords: biopsy; differential diagnosis; osteoblastoma-like osteosarcoma