Bone & joints
Osteosarcoma
Periosteal osteosarcoma
Author: Nat Pernick, M.D.
Topic Completed: 1 November 2016
Minor changes: 29 December 2020
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed search: periosteal [title] osteosarcoma
Table of Contents
Definition / general | Radiology description | Radiology images | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Molecular / cytogenetics description | Differential diagnosisCite this page: Pernick N. Periosteal osteosarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/boneperiostealosteo.html. 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
Xray
Case reports
- 15 year old boy with tibial tumor (Arch Pathol Lab Med 2003;127:e229)
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
Femur
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
