Periosteal Osteosarcoma

Abstract

Periosteal osteosarcoma is an intermediate-grade chondroblastic osteosarcoma arising on the surface of bone. It has a slight female predominance. Most patients are in the second and third decades of life. The median age is 18 years. The most common location is the diaphyseal region of the femur followed by the tibia. Radiologically, the tumor demonstrates a broad-based attachment to the cortex associated with cortical thickening and scalloping of the underlying bone. Histologically, it predominately contains lobules of malignant hyaline cartilage with obvious cytologic atypia. Peripheral condensation and spindling of the tumor cells are commonly seen. Malignant osteoid, often in the form of spicules arrayed perpendicular to the cortical surface, is usually found in the center of the cartilage lobules. Treatment is surgical resection with a wide margin. The role of neoadjuvant and adjuvant chemotherapy is unclear.