Abstract
We describe a case history of a 24-year-old male with osteogenesis imperfecta (OI) who developed osteosarcoma of the left thigh. High-dose ifosfamide therapy caused marked tumor regression of multiple lung metastases. Immunohistochemically, the tumor cells were diffusely positive for the p53 protein. Mutation of the p53 gene was not detected by direct genomic sequencing of exons 4–8. The radiographic characteristics, including irregularly distributed osteolytic lesions and cortical discontinuity, should not be confused with hyperplastic callus formation, a benign process. A biopsy is critical to establish the differential diagnosis between osteosarcoma and common hyperplastic callus formation in OI; however, it must be applied with great care.
References
Andreassen A, Oyjord T, Hovig E, Holm R, Florenes VA (1993) p53 abnormalities in different subtypes of human sarcomas. Cancer Res 53:468–471
Bedi HS, Kaufman DV, Choong PF, Slavin JL (1999) Osteosarcoma of the scapula arising in osteogenesis imperfecta. Pathology 31:52–54
Dorfman HD, Czerniak B (1998) Reactive and natabolic conditions simulating neoplasm of bone. Bone tumors. Mosby, Missouri, pp 1120–1194
Feugeas O, Guriec N, Babin-Boilletot A, Marcellin L, Simon P (1996) Loss of heterozygosity of the RB gene is a poor prognostic factor in patients with osteosarcoma. J Clin Oncol 14:467–472
Gagliardi JA, Evans EM, Chandnani VP, Myers JB, Pacheco CM (1995) Osteogenesis imperfecta complicated by osteosarcoma. Skeletal Radiol 24:308–310
Greenblatt MS, Bennett WP, Hollstein M, Harris CC (1994) Mutations in the p53 tumor suppressor gene: clues to cancer etiology and molecular pathogenesis. Cancer Res 54:4855–4878
Hall PA, Lane DP (1994) p53 in tumour pathology: can we trust immunohistochemistry?—Revisited! J Pathol 172:1–4
Jewell FC (1940) Osteogenic sarcoma occurring in fragilitas ossium. Radiology 34:741–743
Klenerman L, Ockenden BG, Townsend AC (1967) Osteosarcoma occurring in osteogenesis imperfecta. Report of two cases. J Bone Joint Surg 49:314–323
Lasson U, Harms D, Wiedemann HR (1978) Osteogenic sarcoma complicating osteogenesis imperfecta tarda. Eur J Pediatr 129:215–218
Maiya S, Grimer RJ, Ramaswamy R, Deshmukh NS (2002) Osteosarcoma occurring in osteogenesis imperfecta tarda. Int Orthop 26:126–128
Miller CW, Aslo A, Tsay C, Slamon D, Ishizaki K (1990) Frequency and structure of p53 rearrangements in human osteosarcoma. Cancer Res 50:7950–7954
Miller CW, Aslo A, Campbell MJ, Kawamata N, Lampkin BC (1996) Alterations of the p15, p16, and p18 genes in osteosarcoma. Cancer Genet Cytogenet 86:136–142
Miller CW, Aslo A, Won A, Tan M, Lampkin B (1996) Alterations of the p53, Rb and MDM 2 genes in osteosarcoma. J Cancer Res Clin Oncol 122:559–565
Mousses S, McAuley L, Bell RS, Kandel R, Andrulis IL (1996) Molecular and immunohistochemical identification of p53 alterations in bone and soft tissue sarcomas. Mod Pathol 9:1–6
Pompetti F, Rizzo P, Simon RM, Freidlin B, Mew DJ (1996) Oncogene alterations in primary, recurrent, and metastatic human bone tumors. J Cell Biochem 63:37–50
Pritchard DJ, Finkel MP, Reilly CA Jr (1975) The etiology of osteosarcoma. A review of current considerations. Clin Orthop 111:14–22
Reid BS, Hubbard JD (1979) Osteosarcoma arising in osteogenesis imperfecta. Pediatr Radiol 8:110–112
Rutkowski R, Resnick P, McMaster JH (1979) Osteosarcoma occurring in osteogenesis imperfecta. A case report. J Bone Joint Surg Am 61:606–608
Toguchida J, Yamaguchi T, Ritchie B, Beauchamp RL, Dayton SH (1992) Mutation spectrum of the p53 gene in bone and soft tissue sarcomas. Cancer Res 52:6194–6199
Unni KK (1996) Conditions that commonly simulate primary neoplasm of bone. Dahlin’s bone tumors: general aspects and data on 11087 cases, 5th edn. Lippincott-Raven, New York, pp 355–432
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Takahashi, S., Okada, K., Nagasawa, H. et al. Osteosarcoma occurring in osteogenesis imperfecta. Virchows Arch 444, 454–458 (2004). https://doi.org/10.1007/s00428-004-0985-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-004-0985-5