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Skeletal Radiology
Published in: Skeletal Radiology 7/2016

01-07-2016 | Case Report

Multifocal low-grade central osteosarcoma: a rare case

Authors: Richard Boyle, Bruno Giuffre, S. Fiona Bonar

Published in: Skeletal Radiology | Issue 7/2016

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Abstract

Low-grade central osteosarcoma (LGCOS) is a rare variant of osteosarcoma. We present a rare case of multifocal LGCOS located in two distinct skeletal sites, initially noted as incidental findings on imaging for distant traumatic pathology. Both sites seemed small and innocuous on initial imaging, and were quiescent clinically, illustrating the value of close interval multimodal surveillance scanning.
Literature
1.
Silverman G. Multiple osteogenic sarcoma. Arch Pathol. 1936;21(5):88–95.
2.
Kurt AM, Unni KK, McLeod RA, Pritchard DJ. Low-grade intraosseous osteosarcoma. Cancer. 1990;65(6):1418–28.CrossRefPubMed
3.
Bertoni F, Bacchini P, Fabbri N, Mercuri M, Picci P, Ruggieri P, et al. Osteosarcoma: low-grade intraosseous-type osteosarcoma, histologically resembling parosteal osteosarcoma, fibrous dysplasia, and desmoplastic fibroma. Cancer. 1993;71(2):338–45.CrossRefPubMed
4.
Choong PF, Pritchard DJ, Rock MG, Sim FH, McLeod RA, Unni KK. Low grade central osteogenic sarcoma: a long-term followup of 20 patients. Clin Orthop Relat Res. 1996;322:198–206.CrossRefPubMed
5.
Andresen KJ, Sundaram M, Unni KK, Sim FH. Imaging features of low-grade central osteosarcoma of the long bones and pelvis. Skeletal Radiol. 2004;33(7):373–9.CrossRefPubMed
6.
Unni KK, Dahlin DC, McLeod RA, Pritchard DJ. Intraosseous well-differentiated osteosarcoma. Cancer. 1977;40(3):1337–47.CrossRefPubMed
7.
Anninga JK, Picci P, Fiocco M, Kroon HM, Vanel D, Alberghini M, et al. Osteosarcoma of the hands and feet: a distinct clinico-pathological subgroup. Virchows Arch. 2013;462(1):109–20.CrossRefPubMed
8.
Ellis JH, Siegel CL, Martel W, Weatherbee L, Dorfman H. Radiologic features of well-differentiated osteosarcoma. AJR Am J Roentgenol. 1988;151(4):739–42.CrossRefPubMed
9.
Okada K, Nishida J, Morita T, Kakizaki H, Ishikawa A, Hotta T. Low-grade intraosseous osteosarcoma in northern Japan: advantage of AgNOR and MIB-1 staining in differential diagnosis. Hum Pathol. 2000;31(6):633–9.CrossRefPubMed
10.
Malhas AM, Sumathi VP, James SL, Menna C, Carter SR, Tillman RM, et al. Low-grade central osteosarcoma: a difficult condition to diagnose. Sarcoma. 2012;2012:764796.CrossRefPubMedPubMedCentral
11.
Kenan S, Ginat DT, Steiner GC. Dedifferentiated high-grade osteosarcoma originating from low-grade central osteosarcoma of the fibula. Skeletal Radiol. 2007;36(4):347–51.CrossRefPubMed
12.
Simpfendorfer CS et al. Does the presence of focal normal marrow fat signal within a tumor on MRI exclude malignancy? An analysis of 184 histologically proven tumors of the pelvic and appendicular skeleton. Skeletal Radiol. 2008;37(9):797–804.CrossRefPubMed
13.
Antonescu CR, Huvos AG. Low-grade osteogenic sarcoma arising in medullary and surface osseous locations. Am J Clin Pathol. 2000;114(Suppl):S90–103.PubMed
14.
15.
Bonar SF. Central low-grade osteosarcoma: a diagnostic challenge. Skeletal Radiol. 2012;41(4):365–7.CrossRefPubMed
16.
Ogose A, Hotta T, Emura I, Imaizumi S, Takeda M, Yamamura S. Repeated dedifferentiation of low-grade intraosseous osteosarcoma. Hum Pathol. 2000;31(5):615–8.CrossRefPubMed
17.
Franceschina MJ, Hankin RC, Irwin RB. Low-grade central osteosarcoma resembling fibrous dysplasia: a report of two cases. Am J Orthop (Belle Mead NJ). 1997;26(6):432–40.
18.
Muramatsu K, Hashimoto T, Seto S, Gondo T, Ihara K, Taguchi T. Low-grade central osteosarcoma mimicking fibrous dysplasia: a report of two cases. Arch Orthop Trauma Surg. 2008;128(1):11–5.CrossRefPubMed
19.
Franchi A, Bacchini P, Della Rocca C, Bertoni F. Central low-grade osteosarcoma with pagetoid bone formation: a potential diagnostic pitfall. Mod Pathol. 2004;17(3):288–91.CrossRefPubMed
20.
Klein MJ, Siegal GP. Osteosarcoma: anatomic and histologic variants. Am J Clin Pathol. 2006;125(4):555–81.CrossRefPubMed
21.
Steiner GC, Forest M, Vacher-Lavenu MC. Ultrastructure of low-grade intraosseous osteosarcoma of bone: a comparative study with fibrous dysplasia and parosteal osteosarcoma. Ultrastruct Pathol. 2006;30(4):293–9.CrossRefPubMed
22.
Pollandt K, Engels C, Kaiser E, Werner M, Delling G. Gsalpha gene mutations in monostotic fibrous dysplasia of bone and fibrous dysplasia-like low-grade central osteosarcoma. Virchows Arch. 2001;439(2):170–5.CrossRefPubMed
23.
Idowu BD, Al-Adnani M, O’Donnell P, Yu L, Odell E, Diss T, et al. A sensitive mutation-specific screening technique for GNAS1 mutations in cases of fibrous dysplasia: the first report of a codon 227 mutation in bone. Histopathology. 2007;50(6):691–704.CrossRefPubMed
24.
Park HR, Jung WW, Bertoni F, Bacchini P, Park JH, Kim YW, et al. Molecular analysis of p53, MDM2 and H-ras genes in low-grade central osteosarcoma. Pathol Res Pract. 2004;200(6):439–45.CrossRefPubMed
25.
Lee WI, Bacchni P, Bertoni F, Maeng YH, Park YK. Quantitative assessment of HER2/neu expression by real-time PCR and fluorescent in situ hybridization analysis in low-grade osteosarcoma. Oncol Rep. 2004;12(1):125–8.PubMed
26.
Yoshida A, Ushiku T, Motoi T, Shibata T, Beppu Y, Fukayama M, et al. Immunohistochemical analysis of MDM2 and CDK4 distinguishes low-grade osteosarcoma from benign mimics. Mod Pathol. 2010;23(9):1279–88.CrossRefPubMed
27.
Dujardin F et al. MDM2 and CDK4 immunohistochemistry is a valuable tool in the differential diagnosis of low-grade osteosarcomas and other primary fibro-osseous lesions of the bone. Mod Pathol. 2011;24(5):624–37.CrossRefPubMed
28.
Yoshida A, Ushiku T, Motoi T, Beppu Y, Fukayama M, Tsuda H, et al. MDM2 and CDK4 immunohistochemical coexpression in high-grade osteosarcoma: correlation with a dedifferentiated subtype. Am J Surg Pathol. 2012;36(3):423–31.CrossRefPubMed
29.
Ragazzini P, Gamberi G, Benassi MS, Orlando C, Sestini R, Ferrari C, et al. Analysis of SAS gene and CDK4 and MDM2 proteins in low-grade osteosarcoma. Cancer Detect Prev. 1999;23(2):129–36.CrossRefPubMed
30.
Nishio J, Iwasaki H, Takagi S, Seo H, Aoki M, Nabeshima K, et al. Low-grade central osteosarcoma of the metatarsal bone: a clinicopathological, immunohistochemical, cytogenetic and molecular cytogenetic analysis. Anticancer Res. 2012;32(12):5429–35.PubMed
31.
Jeon DG, Koh JS, Cho WH, Song WS, Kong CB, Cho SH, et al. Clinical outcome of low-grade central osteosarcoma and role of CDK4 and MDM2 immunohistochemistry as a diagnostic adjunct. J Orthop Sci. 2015;20(3):529–37.CrossRefPubMed
32.
Lietman SA, Ding C, Levine MA. A highly sensitive polymerase chain reaction method detects activating mutations of the GNAS gene in peripheral blood cells in McCune-Albright syndrome or isolated fibrous dysplasia. J Bone Joint Surg Am. 2005;87(11):2489–94.CrossRefPubMed
33.
Lee SE, Lee EH, Park H, Sung JY, Lee HW, Kang SY, et al. The diagnostic utility of the GNAS mutation in patients with fibrous dysplasia: meta-analysis of 168 sporadic cases. Hum Pathol. 2012;43(8):1234–42.CrossRefPubMed
34.
Carter JM, Inwards CY, Jin L, Evers B, Wenger DE, Oliveira AM, et al. Activating GNAS mutations in parosteal osteosarcoma. Am J Surg Pathol. 2014;38(3):402–9.CrossRefPubMed
35.
Iemoto Y, Ushigome S, Fukunaga M, Nikaido T, Asanuma K. Case report 679: central low-grade osteosarcoma with foci of dedifferentiation. Skeletal Radiol. 1991;20(5):379–82.CrossRefPubMed
36.
Mirra JM. Osseous tumors of intramedullary origin. In: Bone Tumors. Clinical, radiologic and pathologic correlations. Vol 1. London: Lea and Febiger Philadelphia; 1989. p 143–488.
37.
Price CH, Truscott DE. Multifocal osteogenic sarcoma; report of a case. J Bone Joint Surg (Br). 1957;39-b(3):524–33.
38.
Amstutz HC. Multiple osteogenic sarcomata: metastatic or multicentric? Report of two cases and review of literature. Cancer. 1969;24(5):923–31.CrossRefPubMed
39.
Daffner RH, Kennedy SL, Fox KR, Crowley JJ, Sauser DD, Cooperstein LA. Synchronous multicentric osteosarcoma: the case for metastases. Skeletal Radiol. 1997;26(10):569–78.CrossRefPubMed
40.
Enneking WF, Springfield D, Gross M. The surgical treatment of parosteal osteosarcoma in long bones. J Bone Joint Surg Am. 1985;67(1):125–35.PubMed
41.
Hatori M, Ohtani H, Yamada N, Uzuki M, Kokubun S. Synchronous multifocal osteosarcoma with lymphatic spread in the lung: an autopsy case report. Jpn J Clin Oncol. 2001;31(11):562–6.CrossRefPubMed
42.
Bacci G, Picci P, Ferrari S, Mercuri M, Briccoli A, Donati D, et al. Synchronous multifocal osteosarcoma: results in twelve patients treated with neoadjuvant chemotherapy and simultaneous resection of all involved bones. Ann Oncol. 1996;7(8):864–6.CrossRefPubMed
43.
Meyers PA, Heller G, Healey J, Huvos A, Lane J, Marcove R, et al. Chemotherapy for nonmetastatic osteogenic sarcoma: the Memorial Sloan-Kettering experience. 1992;10(1):5–15.
44.
McCarthy EF, Tolo VT, Dorfman HD. Case report 446. Multicentric, metachronous, low-grade, sclerosing osteogenic sarcoma. Skeletal Radiol. 1987;16(7):592–6.CrossRefPubMed
45.
Arkader A, Huvos AG, Healey JH. Multifocal synchronous low-grade intramedullary and juxtacortical osteogenic sarcoma. Clin Orthop Relat Res. 2007;465:265–70.PubMed
Metadata
Title
Multifocal low-grade central osteosarcoma: a rare case
Authors
Richard Boyle
Bruno Giuffre
S. Fiona Bonar
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 7/2016
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-016-2384-9

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