Parosteal osteosarcoma associated with a low-grade component mimicking well-differentiated liposarcoma: a case report
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CASE REPORT
Parosteal osteosarcoma associated with a low-grade component mimicking well-differentiated liposarcoma: a case report P. Sohier 1,2 & M. Rodrigues 3 & P. Anract 4,2 & A. Feydy 5,2 & F. Larousserie 1,2 Received: 6 April 2020 / Revised: 3 June 2020 / Accepted: 7 June 2020 # ISS 2020
Abstract Parosteal osteosarcomas and well-differentiated liposarcomas are both well-differentiated locally aggressive tumors. They both have simple karyotypes with amplification of the 12q13-15 regions including MDM2 and CDK4 genes. In this report, we describe the case of a parosteal osteosarcoma intertwined with a low-grade component similar to a well-differentiated liposarcoma. The association of a bone component with an adipose component was initially overlooked. We describe the histological, imaging, and molecular characteristics of this tumor stressing the importance of radio-pathological correlation. To our knowledge, this is the second report of a parosteal osteoliposarcoma. Awareness of this rare presentation may allow radiologists and surgeons to recognize the peripheral fatty component as an integral part of the tumor. Keywords Parosteal osteosarcoma . Well-differentiated liposarcoma . Parosteal osteoliposarcoma . Radio-pathological correlation
Introduction Parosteal osteosarcoma (OS) is a rare primary bone tumor, accounting for approximately 4% of all OSs [1]. Peak incidence is in the third and fourth decades. These tumors are located on the surface of the metaphyseal region of the distal femur (around 60% of cases), the proximal tibia, or proximal humerus.
This case was awarded the Corinne Farrell Best Case Report Presentation at the 2013 ISS Members’ Meeting. * F. Larousserie [email protected] 1
Department of Pathology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP.Centre – Université de Paris, 27 rue du Faubourg-Saint-Jacques, 75694 Paris Cedex 14, France
2
Université de Paris, Paris, France
3
INSERM U509, Laboratoire de Pathologie Moléculaire des Cancers, Institut Curie, Paris, France
4
Orthopaedic Surgery Departement, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP.Centre – Université de Paris, Paris, France
5
Radiology B Department, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP.Centre – Université de Paris, Paris, France
Parosteal OS is a slowly growing tumor that may recur and rarely metastasizes [2–4]. In parosteal OSs, radiographs typically demonstrate an ossified cortically based mass arising from the surface of the metaphysis of a long bone. On axial computed tomography (CT), attachment to the cortex may be broad or narrow. A partial radiolucent cleavage plane, representing the periosteum, may be apparent between the ossified mass and the cortex. Magnetic resonance imaging (MRI) is useful to assess the soft-tissue extent and identify any non-osseous component. Microscopically, parosteal OS is characterized by trabeculae of woven bone surrounded by a paucicellular spindle cell proliferation in a fibrous background. Atypia is usually mini
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