Diagnosis, Treatment and Prognosis of Low Grade Central Osteosarcoma

Abstract

Purpose We analyzed the diagnosis and the treatment outcomes of patients with central low grade osteosarcoma. Materials and Methods We retrospectively reviewed 16 patients with central low grade osteosarcoma were treated at out institution between 1994 and 2011. Results There were 4 men and 12 women with mean age of 26 years. Eleven patients were correctly diagnosed but 5 patients were misdiagnosed as osteoid osteoma, non ossifying fibroma, aneurysmal bone cyst, desmoplastic fibroma. 15 patients finally received wide margin en bloc excision and one of them treated under neoadjuvant chemotherapy. Final survival status was continuous disease free in 14 and 1 patient died of renal cell cancer. Remaining 1 with multifocal lesions is alive with disease for 7 years only treated radiation therapy on residual tumors. Nine (56%) of 16 tumors showed extraosseous extension of tumor (56%) and 1 of them showed extra-compartmental tumors. Conclusion The diagnosis of central low grade osteosarcoma is challenging, however, considering of the clinical suspicion, the typical findings of radiologic and pathologic features, proper diagnosis is needed. This tumor should be treated with wide excision, even after an intralesional excision, to avoid local recurrence or transformation to higher histologic grade.