Radiology. 2003 Nov;229(2):545-53. Epub 2003 Sep 25.
Telangiectatic osteosarcoma: radiologic-pathologic comparison.
Murphey MD, wan Jaovisidha S, Temple HT, Gannon FH, Jelinek
JS, Malawer MM.
Department of Radiologic Pathology, Armed
Forces Institute of Pathology, 6825
16th Street NW, Bldg 54, Rm M127A, Washington, DC 20306, USA.
PURPOSE: To describe the imaging characteristics
of a large series of
telangiectatic osteosarcomas with pathologic findings for
AND METHODS: The authors retrospectively reviewed 40 pathologically
telangiectatic osteosarcomas. Patient demographics and images
(n = 36), bone scintigraphy (n = 17), angiography (n = 4),
(CT) (n = 25), and magnetic resonance (MR) imaging (n = 27)
were evaluated by
three authors in consensus for lesion location, size, and
characteristics. There were 27 men (68%) and 13 women (32%)
in the study, with
an age range of 4-83 years (mean age, 24 years).
affected the femur, tibia, and humerus. Radiographs showed
lysis, a wide zone of transition, and matrix mineralization.
CT demonstrated low
attenuation, MR demonstrated high signal intensity on T2-weighted
both demonstrated hemorrhage, which simulated the appearance
of aneurysmal bone
cyst. Viable sarcomatous tissue surrounding hemorrhagic and/or
was best seen at contrast material-enhanced CT and MR imaging,
peripheral, septal, and nodular enhancement in all cases.
mineralization in this viable tissue was best seen at CT.
soft-tissue mass was also seen in 19 of 25 cases (76%) at
CT and in 24 of 27
cases (89%) at MR imaging.
CONCLUSION: CT and MR imaging findings
telangiectatic osteosarcoma often include thick nodular tissue
mineralization at CT) in a largely hemorrhagic and/or necrotic
with an associated soft-tissue mass, which allows distinction
Cancer. 2003 Jun 15;97(12):3068-75.
Neoadjuvant chemotherapy for
high-grade central osteosarcoma of the extremity.
Histologic response to preoperative chemotherapy correlates
subtype of the tumor.
Bacci G, Bertoni F, Longhi A, Ferrari
S, Forni C, Biagini R, Bacchini P, Donati
D, Manfrini M, Bernini G, Lari S.
Department of Musculoskeletal Oncology,
Istituto Ortopedico Rizzoli, Bologna,
BACKGROUND: In primary central high-grade
osteosarcoma, a number of distinct
subtypes have been identified, but little is known about the
METHODS: The authors investigated whether the
with histologic response to chemotherapy in 1058 patients
with osteosarcoma of
the extremities who were treated with neoadjuvant chemotherapy
over the last 20
years. The tumors were classified as osteoblastic (70%), chondroblastic
fibroblastic (9%), and telangiectatic (6%). At diagnosis,
911 patients had
localized disease and 147 had resectable lung metastases.
RESULTS: The response
to preoperative chemotherapy was good (90% or more tumor necrosis)
in 59% of
patients and poor (< 90% tumor necrosis) in 41% of patients.
The rate of good
responses was significantly higher (P = 0.0001) in the fibroblastic
telangiectatic (80%) tumors and significantly lower in chondroblastic
(43%). Prognosis was significantly correlated with the histologic
5-year overall survival rate was significantly higher (P =
fibroblastic (83%) and telangiectatic (75%) tumors than in
and chondroblastic (60%) tumors. In all subtypes, except for
subtype, the 5-year overall survival rate was significantly
higher (P = 0.0001)
in good responders P = 0.0001 (68%) than in poor responders
The authors concluded that the histologic subtype of primary
osteosarcoma of the extremity was strictly correlated with
to chemotherapy and probably, as a consequence, also with
studies are needed to establish whether these results justify
therapeutic approach based on the histologic subtype of the
Zhonghua Bing Li Xue Za Zhi. 2002 Jun;31(3):213-6.
a clinicopathologic analysis of 14 cases.
Liu H, Huang X.
Department of Pathology, Beijing Jishuitan
Hospital, Beijing 100035, China.
OBJECTIVE: To investigate the clinicopathologic
characteritics and prognosis of
METHODS: The clinical and pathological
data of 14
cases of telangiectatic osteosarcoma were reviewed.
Most of these
patients were male (9/14). The mean age was 23 years. Most
tumors were located
in the lower extremities (10/14). The roentgenograms showed
a large purely
osteolytic lesion. Both medullar and cortical bone were extensively
The gross specimen showed cystic cavities separated by septa,
similar to an
aneurismal bone cyst. Microscopically, the septa contained
anaplastic cells. A
few fine, lace-like osteoid were scattered among these sarcomatous
patients were followed-up from 6 months to 84 months. Of seven
patients who had
developed pulmonary metastasis, six patients died and one
alive with lung
metastasis. The remaining five patients survived after operation.
Difficulties in making an early diagnosis and highly malignant
of this disease
might be the important factors that affect the prognosis of
Mod Pathol. 2001 Dec;14(12):1277-83.
Clinicopathologic analysis of
HER-2/neu immunoexpression among various
histologic subtypes and grades of osteosarcoma.
Kilpatrick SE, Geisinger KR, King TS,
Sciarrotta J, Ward WG, Gold SH, Bos GD.
Department of Pathology, University of
North Carolina, Chapel Hill, North
Carolina 27599-7525, USA. firstname.lastname@example.org
Overexpression of the HER-2/neu oncogene
appears to have prognostic significance
in breast cancer. Recently, some have reported a relationship
immunohistochemical expression in osteosarcoma and poor clinical
Despite limited data, a pilot trial of Herceptin, which targets
product, has been initiated for the therapy of some metastatic
(CCG-P9852). Archival formalin-fixed, paraffin-embedded tissue
obtained from 41
patients diagnosed with osteosarcoma was examined immunohistochemically
antibodies against the HER-2/neu oncogene product: CB-11 (monoclonal,
Oncor (polyclonal, 1/200). All but one tumor (case of recurrent
parosteal osteosarcoma) represented primary tumor samples;
when applicable, only
prechemotherapy biopsies were analyzed. The study sample included
spectrum of histologic subtypes and grades of osteosarcoma
(25 conventional high
grade; 3 telangiectatic; 1 small cell; 6 parosteal; 1 periosteal;
low-grade intramedullary). A case of metastatic breast cancer
overexpression of the HER-2/neu oncogene served as the positive
Complete membranous positivity, considered prognostically
significant in breast
cancer, was not seen in any of our osteosarcoma cases. At
cytoplasmic positivity was documented in 40 (98%) tumors using
the CB11 antibody
and in 34 (83%) using the Oncor antibody. The intensity of
staining (0, 1-3+) did not correlate with histologic subtype/grade,
chemotherapy (<90% versus > or = 90% necrosis), metastasis,
Immunohistochemical overexpression of the HER-2/neu oncogene,
complete membranous positivity, is not present in our series
Cytoplasmic positivity is observed in most osteosarcomas,
histologic subtype/grade, and is not associated with response
chemotherapy or disease progression.
Pathology. 1999 Nov;31(4):428-30.
with features of telangiectatic osteosarcoma.
Radhi JM, Loewy J.
Department of Pathology, College of Medicine,
Royal University Hospital,
University of Saskatchewan, Saskatoon, Canada.
We describe a 44-year-old female with
a known history of a solitary
osteochondroma of the scapula followed on X-ray for five years.
presented with a rapidly growing lump. Imaging studies confirmed
the presence of
an aggressive looking lesion. Excision was performed and pathology
dedifferentiated chondrosarcoma with features of a telangiectatic
Hum Pathol. 1999 Oct;30(10):1254-9.
Large cell, epithelioid, telangiectatic
osteoblastoma: a unique
pseudosarcomatous variant of osteoblastoma.
Angervall L, Persson S, Stenman G, Kindblom
Department of Pathology, Sahlgrenska University
Hospital, Goteborg, Sweden.
A previously undescribed large-cell, epithelioid,
and aneurysmal variant of
osteoblastoma with minimal osteoid-production--simulating
osteosarcoma, epithelioid angiosarcoma, and metastatic carcinoma
The tumor occurred in the mandible of a 14-year-old girl.
The light microscopic,
immunohistochemical, ultrastructural, cell proliferation,
studies, as well as the 7-year disease-free follow-up period
all indicate a
benign osteoblastic tumor. Cytogenetically, the tumor had
karyotype, distinguished by a complex t(1;5;17;22) and a terminal
Recognition of this unique, pseudomalignant variant of osteoblastoma
important to avoid an erroneous diagnosis of malignancy.