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Japanese Journal of Clinical Oncology Advance Access published online on March 13, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi243
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© 2006 Foundation for Promotion of Cancer Research
Received September 10, 2005
Accepted November 29, 2005

Case Report

Report of Four Cases with High-Grade Surface Osteosarcoma

Manabu Hoshi 1, Seiichi Matsumoto 1 *, Jun Manabe 1, Taisuke Tanizawa 1, Toshio Shigemitsu 1, Kengo Takeuchi 2, and Noriyoshi Kawaguchi 1

1 Department of Orthopaedic Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
2 Department of Pathology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

* To whom correspondence should be addressed.
Seiichi Matsumoto, E-mail: smatsumoto{at}jfcr.or.jp


  Abstract

High-grade surface osteosarcoma is the rarest of the three types of surface osteosarcoma. Four cases with high-grade surface osteosarcoma arising from the distal femur and tibia are reported in this study. One patient was previously diagnosed with Turner's syndrome. Radiologically, three cases presented characteristic appearances suggesting high-grade bone-forming sarcoma arising from the bone surface; however, one case was similar to other juxtacortical lesions such as periosteal and parosteal osteosarcoma, which typically have a better prognosis than high-grade surface osteosarcoma. Therefore, all cases underwent biopsy to determine a definitive diagnosis. Our strategy of treatment for high-grade surface osteosarcoma was a combination of wide resection and pre-/post-operative chemotherapy, equivalent to the treatment for conventional intramedullary osteosarcoma. At the last follow-up, two cases were still undergoing chemotherapy, one case was continuously disease free during the follow-up period of 81 months, and one patient was living with no evidence of disease 60 months after surgery. The aim of this study is to report the clinical information, oncological outcome and appropriate treatment for high-grade surface osteosarcoma.

Keywords: high-grade surface osteosarcoma; wide resection; chemotherapy; Turner's syndrome.
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