Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Tumours
Abstract number: 24114
LOW GRADE OSTEOSARCOMA, PAROSTEAL OR INTRAOSSEOUS, A RARELY
RECOGNIZED ENTITY, WITH POSSIBLE LONG TERM DISASTROUS SURGICAL
CONSEQUENCES; CLINICAL AND HISTOPATHOLOGICAL PRESENTATION OF
FOUR CASES, TWO OF THEM SYMPTOMATIC FOR EIGHT TO TEN YEARS.
Doina POP, Mihai POPESCU
Faculty of Medicine Carol Davila Bucharest, Bucharest (ROMANIA)
Juxtacortical or intramedullary, well diferentiated osteosarcoma is clinically
characterized by a long term history of dull pain and swelling and a histopathological
frame of fibro-osseous proliferation with subtle minimal atypia. Radiographically, the
malignant appearance, especially in early phases is overlooked though
retrospectively recognized. Fallacious attitudes by non action may result in big
tumors, possibly deddiferenciated, manageable only by radical surgery.The actual
presentation focuses on some of our extreme cases, two with very early nonspecific
clinical findings but histologically recognizable as malignant and two others evolving
for 8-10 years, as slowly growing expansible masses, at the time of presentation
necessitating radical surgery. All patients were women in the second decade of life.
As to the localization, one was proximal humeral, two proximal tibial and one distal
tibial. The humeral and one proximal tibial were parosteal osteosarcomas with soft
tissue involvement but retaining the histological features of well differentiated
osteosarcomas.Two other cases, with proximal juxtacortical and distal intramedullary
tibial localization were radiologically early lesions imitating a sessile
osteochondroma and respectively a bone cyst. The histological diagnosis of
osteosarcoma was regarded with suspicion.The aim of this presentation is to draw
attention on histological features of parosteal and well differentiated intramedullary
osteosarcoma and its clinical and radiological misleading behavior.
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