Bone & joints


Periosteal osteosarcoma

Topic Completed: 1 November 2016

Minor changes: 29 December 2020

Copyright: 2003-2021,, Inc.

PubMed search: periosteal [title] osteosarcoma

Nat Pernick, M.D.
Page views in 2020: 2,917
Page views in 2021 to date: 2,425
Cite this page: Pernick N. Periosteal osteosarcoma. website. Accessed October 27th, 2021.
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

AFIP images

Slight cortical thickening

Contributed by Dr. Mark R. Wick

Femur diaphyseal xray


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

AFIP images

Cross section

Contributed by Dr. Mark R. Wick


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

AFIP images

Malignant cartilage

Neoplastic osteoid

Spiculation of bone

Contributed by Dr. Mark R. Wick

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