Bone
Osteosarcoma - variants
Periosteal osteosarcoma

Author: Nat Pernick, M.D. (see Authors page)

Revised: 30 November 2016, last major update November 2016

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed search: periosteal [title] osteosarcoma

Cite this page: Periosteal osteosarcoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/boneperiostealosteo.html. Accessed August 24th, 2017.
Definition / general
  • < 2% of all osteosarcomas
  • Same age as conventional osteosarcoma, slight female predominance
  • Related to periosteal chondrosarcoma
  • Sites: usually diaphysis of proximal tibia or femur
Radiology description
  • Small lucent lesions on bone surface with bone spicules perpendicular to shaft and penetrating soft tissues
  • No medullary involvement (by definition)
  • Good prognosis (better than high grade osteosarcoma, poorer than parosteal osteosarcoma or juxtacortical chondrosarcoma), with high local recurrence rate and 15% metastatic rate
Radiology images
Images hosted on PathOut server:

Femur diaphyseal xray - contributed by Dr. Mark R. Wick

Xray - contributed by Dr. Mark R. Wick

Slight cortical thickening

Case reports
Gross description
  • Grows on surface of long bones
  • Limited to cortex with only rare medullary invasion
Gross images
Images hosted on PathOut server:

Femur - contributed by Dr. Mark R. Wick

Contributed by Dr. Mark R. Wick

Cross section

Microscopic (histologic) description
  • Intermediate to high grade osteosarcoma with prominent cartilaginous component
  • Cartilage in lobules with peripheral spindling and central bone formation
  • Malignant osteoid / bone is present, but may be focal
Microscopic (histologic) images
Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick


Malignant cartilage

Neoplastic osteoid

Spiculation of bone




Images hosted on other servers:

Xray, gross, H&E

Molecular / cytogenetics description
  • Usually diploid
Differential diagnosis
  • Juxtacortical chondrosarcoma: lobules of malignant cartilage with calcification and surface endochondral ossification; no malignant osteoid