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PubMed1992

Case report 714. Postirradiation osteosarcoma after radiation of metastatic skeletal lesion.

Two cases of postirradiation osteosarcoma are presented--one in a 76-year-old woman with breast carcinoma and subsequent osteosarcoma after radiation therapy for a metastatic lesion in the right tibia, and the other in a 16-year-old girl with hepatocellular carcinoma metastatic to the left tibia and osteosarcoma after radiation therapy to that bone. Microscopically, both cases were high-grade spindle cell lesions with osteoid production. Both patients fared poorly. This is a rare complication of radiation therapy.

Adenocarcinoma↗

PubMed1980

The biology, pathology and immunology of a virus induced rat osteosarcoma. I. Biological behaviour and histopathology.

The biological behaviour and histopathology of an experimental osteosarcoma in rats are described as a model to study the human disease. The tumour was developed by injection of Moloney murine sarcoma virus into the tibial marrow space of three strains of inbred new-born rats. The resulting neoplasm was highly malignant and arose after a short latent period of only 10 days. It was readily maintained in tissue culture and was transplantable to adult rats. The virus induced tumour resembled human osteosarcoma in pattern of growth, tumour osteoid production, reaction of adjacent bony tissues and distribution of metastases, being an excellent model for the study of the interaction between oncogenic viruses and skeletal tissues. The analogies and differences between this and other virus-induced murine tumours and human osteosarcoma are discussed.

Animals↗

PubMed1995

Primary osteosarcoma of the L2 lamina presenting as "silent" paraplegia: case report and review of the literature.

Primary osteosarcomas of the vertebral column are not common, and to our knowledge a total of 78 cases, mostly located in the vertebral body, have been previously reported. We report a primary osteosarcoma of the spine with an extremely rare location--the lamina of the second lumbar vertebra. The patient, a 38-year-old woman, was admitted with paraplegia of a short duration without pain. Preoperatively, the patient underwent CT scanning for staging (Enneking IIB) followed by a needle biopsy and local preoperative arterial embolization. An emergency decompressive laminectomy was performed, and stabilization was carried out using methylacrylate. The patient showed a complete neurologic recovery. Combined chemotherapy and local irradiation did not prevent tumor recurrences, which occurred 12 and 19 months after the initial intervention and were associated with recurrent neurologic impairment. The patient died 19 months after the initial presentation, while in paraplegia, from lung metastases. Based on our unique observation, it seems that in primary osteosarcomas located in the posterior elements of the spin, the symptoms are not specific, and the disease may only become manifest when the tumor is no longer resectable. When the tumor is associated with neurologic impairment, spinal canal decompression should be performed even though it does not radically resect the tumor because it significantly improves the quality of the patient's life.

Adult↗

PubMed1994

Osteosarcoma of the skull. Report of a post-Paget and post-radiation case in an elderly woman.

Osteosarcomas rarely affect the skull, preferring the long bones. As at other sites, osteosarcomas of the skull may be classified chiefly as de novo, post-radiation and post-Paget cases. Plain films of the skull and, even more, CT and MRI are the key diagnostic procedures for this disease. The treatment is surgery plus chemotherapy, in some cases radiotherapy. We report an odd case of post-radiation and post-Paget osteosarcoma in an elderly woman whose sister had been similarly affected.

Aged↗

PubMed1986

The angiographic response of osteosarcoma following pre-operative chemotherapy.

The prognosis of osteosarcoma has improved significantly with recent advances in chemotherapy. Evaluation of the effect of chemotherapy is important for optimal timing of surgery, for selecting an alternative drug regimen in instances of poor response to chemotherapy and for testing combinations of new drugs. The purpose of this paper is to define the value of plain radiographs and angiography in assessing tumor response to chemotherapy. Studies were obtained before and after chemotherapy. The radiographic results were correlated with histologic evaluation of the resected specimen. Patients with less than 10% residual viable tumor in the resected bone were designated "responders" and patients with more than 10% of remaining viable tumor were "nonresponders". Angiographic appearances correctly separated 15 patients with good response to chemotherapy from seven patients who were not responsive. Conversely, comparison of plain radiographs obtained before and after chemotherapy did not allow a reliable differentiation between patients with good, poor, or no response to chemotherapy. The current role of angiography in the management of patients with osteosarcoma is discussed. It is concluded that - in contrast to plain film radiography - angiography is an accurate method for assessing the response of osteosarcoma to chemotherapy.

Adolescent↗

PubMed1987

Morphology of pulmonary metastases from osteosarcoma during chemotherapy.

Osteosarcoma is known to metastasize rather early, and even after surgical resection of the primary metastases may occur predominantly in the lung. Administration of polychemotherapy for destruction of micrometastases has served to improve prognosis. Preoperative chemotherapy facilitates the evaluation of regression, another factor of high prognostic relevance. Morphologic analysis of pulmonary metastases developing during chemotherapy is of considerable interest on account of the potential therapy resistance of certain histologic subtypes of osteosarcoma. In the present study pulmonary metastases resected in 20 thoracotomies of 15 osteosarcoma patients were investigated by light microscopy and compared, if possible, to the respective primaries. All patients had received chemotherapy, predominantly according to the COSS 80 and COSS 82 protocols. The histologic picture of a tumor was found to change from the primary to the pulmonary metastasis, a pattern also verified in the lung metastases collected in consecutive thoracotomies from the same patient. Several different subtypes were regularly found side by side in the metastases, but generally no special sensitivity or resistance to chemotherapy could be attributed to any of these subtypes. Our results nevertheless do indicate an increased resistance of anaplastic tumor tissue. The response to chemotherapy agreed in 9 of 10 primaries with that of their metastases.

Adolescent↗

PubMed1979

Ultrastructure of telangiectatic osteosarcoma.

Recent investigations have shown that telangiectatic osteosarcoma has a poorer prognosis than other osteosarcomas. To elucidate the histogenesis of TOS two cases were investigated on the electron microscopic level. The results show that besides anaplastic, osteoblast-like, and fibroblast-like tumor cells angiosarcomatous components can be observed in this malignant bone tumor, which are characterized by endothelial cells with pinocytotic vesicles, tight intercellular junctions, fine fibrils, and so-called Weibel-Palade bodies in their cytoplasm. From these results, it is concluded that telangiectatic osteosarcoma is derived from multipotent mesenchymal cells with potential differentiation into various directions, such as osteoblast-like cells, and fibroblast-like cells.

Adolescent↗

PubMed1983

Biologic characterization of human bone tumors. II. Distribution of different collagen types in osteosarcoma--a combined histologic, immunofluorescence and electron microscopic study.

Sixteen cases of typical highly malignant osteosarcoma were investigated by light, electron, and immunofluorescence microscopy to demonstrate the presence of collagen types I-III. It was shown that, in light-microscopically anaplastic areas of the tumor, collagen type III predominates, while only very few membranes of collagen type I are observed. Ultrastructurally, the cells are characterized by numerous free ribosomes in their cytoplasm and only a few membranes of granular endoplasmic reticulum (ER). In osteoblastic areas, collagen type I is increased, while type-III collagen is decreased. The cytoplasm of cells contains markedly more granular ER. An increasing mineralization of matrix is observed. In fibroblastic areas of the tumors, collagen types I and III are codistributed. Tumor cells have a fibroblast appearance with elongated nuclei and well developed granular ER. The chondroblastic areas, characterized by immature neoplastic cartilage, contain varying amounts of collagen type II. Chondroblast-like tumor cells have typical ring-shaped membranes of granular ER in their cytoplasm. The evidence of different collagen types in osteosarcomas lends additional support to the concept that a pluripotent mesenchymal cell is the stem cell of osteosarcomas.

Adolescent↗

PubMed1982

Digital picture analysis for studying the development of experimentally induced osteosarcoma.

We used the method of digital picture analysis to make a quantitative characterization, of stages of development of experimental osteosarcomas in rabbits. DMBA in gelatine pellets placed intraosteally served as a carcinogen to induce bone sarcomas. Of 25 animals treated, eight developed osteosarcomas classified as either osteoblastic, fibroblastic, or chondroblastic. We studied the process of bone neoplasia using radiographic, scintigraphic, and histological methods. To define the progress of neoplastic growth in each tumor we processed sequential radiographs of them by digital picture analysis. For this purpose, we developed a method for quantifying radiological changes using parameters independent of the rotation of the bone. In defining the histologic type of bone sarcomas, besides microscopic features we relied on quantitative criteria such as ratios of the newly formed bone and cartilage to the sarcomatous stroma. Our results, presented in this paper, indicate that digital picture analysis may be useful in characterizing experimental osteosarcomas as a model for therapeutic studies.

9,10-Dimethyl-1,2-benzanthracene↗

PubMed1976

[Juxtacortical osteosarcoma (author's transl)].

Juxtacortical osteosarcoma should be considered a very rate distinctive entity under all malignant bone tumors. The tumor has a remarkable tendency to grow from the periostal tissues peripherally with a usually marked degree of ossification without primary medullary involvement. It's different und characteristic behavior in clinical, roentgenographic and microscopic findings from that of other types of bone-forming sarkomas is discussed by means of a just treated case. In contrast to osteogenic osteosarcoma the prognosis for early well treated juxtacortical osteosarcoma is much better.

Adult↗

PubMed1977

Aneurysmal bone cyst and telangiectatic osteosarcoma. A histopathological and morphometric study.

In a series of 105 cases of aneurysmal bone cyst, 18 showed an unusually high level of mitotic activity and/or increased nuclear pleomorphism which complicated the differential diagnosis with respect to telangiectatic osteosarcoma. An attempt was made to use semi-automatized morphometric and histophotometric techniques to establish objective morphological differences between these unusual cases of aneurysmal bone cyst and 16 cases of telangiectatic osteosarcoma. Three cases (two of aneurysmal bone cyst and one of telangiectatic osteosarcoma) proved unsuitable for analysis. In 24 of the remaining 31 cases (77%) a computerized discriminant analysis permitted correct discreimination with a high degree of certainty on the basis of quantitative nuclear characteristics determined in paraffin sections. In the other 7 cases the diagnosis was less certain (3), doubtful (2) or erroneous (2). The relevant nuclear characteristics were (in ascending sequence of discrimination): the largest nuclear surface area, the mitotic index, and the percentage of nuclear sections exceeding an arbitrarily chosen limit of 60 micron2. The criterion of nuclear size for discrimination between these benign and malignant lesions could be applied for two reasons: firstly, because a group of extremely large nuclei occur in malignant cases, and secondly, because the average nuclear size is larger in malignant than in benign lesions. The extremely large nuclei occur as only a small percentage of the total nuclear population. The other variables investigated, i.e., cellularity and nuclear contour ratio, did not contribute greatly to the differentiation. In 11 cases, the average nuclear Feulgen extinction was estimated as an additional variable.

Adolescent↗

PubMed1978

Ultrastructural cytology of human osteosarcoma cells.

The cytology of 6 osteosarcomas was examined by electron microscopy. In keeping with the varied pattern of osteosarcomas seen by light microscopy several types of tumor cells could be differentiated: osteoblast-like, fibroblast-like, chondroblast-like, osteoclast-like and histiocyte-like cells. Moreover, atypical malignant mesenchymal cells and vascular spaces were present. The individual cytoplasmic organelles are not considered to be specific to particular types of cell as seen from the discussion of the significance of rough endoplasmic reticulum, microfilaments and lysosomes. Only examination of the composite pattern of subcellular organelles allows the differentiation of certain cell types. All tumor cells visible in osteosarcomas are considered as modifications of a transformed common progenitor cell. Because of the variegated cytological picture a multipotent mesenchymal cell rather than an osteoblastic cell is assumed to be the ancestor cell.

Adolescent↗

PubMed1997

Parosteal osteosarcoma of the tarsus.

Parosteal osteosarcoma is a very rare bone tumor with a predilection for the posterior aspect of the distal femoral metaphysis. A case of parosteal osteosarcoma of the tarsus of a 23-year-old woman is reported. This is the second case of parosteal osteosarcoma of the tarsus reported in the English literature.

Adult↗

PubMed1987

Comparison of quantitative ground substance analysis in biopsy and resected tumour in osteosarcomas.

Osteosarcomas may show variable differentiation. They are divided into osteoblastic, chondroblastic and fibroblastic subgroups depending on their dominant histological differentiation. The pattern of histological differentiation of osteosarcoma is supposed to have an influence on the response to chemotherapy and in this study the relationship between the differentiation of the tumours and response to chemotherapy was examined in 22 osteosarcomas. For this purpose the nuclear size of tumour cells was determined on imprints and the area of the different ground substances on tumour sections after undecalcified preparation. Tumours with little nuclear polymorphism and those with an area of chondroblastic ground substance of more than 20% in the biopsy showed a poor response to chemotherapy. We conclude from our results that lack of nuclear polymorphism and in particular a large area of chondroblastic ground substances in the biopsy, can be regarded as an unfavourable prognostic factor in the response to primary chemotherapy. A comparison of the area of chondroblastic ground substance in biopsy and resection material proves that the biopsy delivers a representative view of the total area of chondroblastic ground substance for the groups of responder and non-responder. Patients with a large amount of chondroblastic ground substance in the biopsy probably require more aggressive chemotherapy.

Adolescent↗

PubMed1997

Phalangeal intraosseous well-differentiated osteosarcoma of the hand.

A case of intraosseous well-differentiated osteosarcoma in one phalanx of the hand is reported. A 78-year-old man noticed swelling in the little finger of his right hand approximately 7 years before referral. Imaging disclosed a tumour with a "ground glass" appearance and irregular mottled calcification occupying almost all of the phalanx marrow and suggested slight invasion into the soft tissue. Open biopsy suggested a diagnosis of well-differentiated fibroblastic osteosarcoma. The finger and its metacarpal bone were amputated and a tumour measuring 3.5 x 2.2 x 2.0 cm and with an indistinct soft tissue margin was found in the bone marrow. Histologically, the tumour was composed of fibroblastic cells with few mitoses, and neoplastic bone formation was apparent. Although the tumour appeared to be a fibrous dysplasia, the presence of nuclear atypia, hypercellularity, and the absence of a typical woven bone pattern in addition to the soft tissue invasion indicated otherwise. Ultrastructural examination showed focal myofibroblastic differentiation, and immunohistochemistry revealed smooth muscle actin, vimentin, osteocalcin, osteonectin and MIBI in the tumour cells. This ultrastructural and immunohistochemical study is believed to be the first detailed report of an intraosseous well-differentiated osteosarcoma of phalangeal bone.

Actins↗

PubMed1995

Composition and posttranslational modification of individual collagen chains from osteosarcomas and osteofibrous dysplasias.

The composition of collagen was analyzed and the degree of lysyl hydroxylation of individual collagen chains was determined in four osteosarcomas and two osteofibrous dysplasias. In addition, the tumor proliferation (number of mitoses, proliferating-nuclear-antigen-positive cells, MIB) as well as the response to chemotherapy (morphological regression grade) were checked. All tumors contained a high proportion of collagen III and, in all but one osteosarcoma, pepsin-extracted collagens I and III were overmodified. Furthermore, the proportion of diglycosides in collagen I was about four times higher than in controls. The collagen composition and modification resembled those of bones at early stages of human development. One osteosarcoma and both osteofibrous dysplasias were in the normal range of lysyl hydroxylation. There was no correlation between the collagen properties and the histopathological marker of tumor proliferation.

Adolescent↗

PubMed1993

High malignant surface osteosarcoma arising at the site of a previously treated aneurysmal bone cyst.

A patient who developed a high malignant surface osteosarcoma at the site of a previously treated aneurysmal bone cyst is reported. The patient developed the osteosarcoma 4 years after complete curettage and bone-grafting of the cyst. The clinical, radiological and light microscopic features of this case are described. A causal relationship between the preexisting aneurysmal bone cyst and osteosarcoma is discussed, but seems to be unlikely.

Adult↗

PubMed1980

[Metastasized osteosarcoma with undifferentiated carcinoma-like parts].

This was the case of a 64-year-old man with osteosarcoma. The biopsy yielded undifferentiated tumor without bone or cartilage formation. Because of high age of the patient and radiological changes present, a metastatic carcinoma was suspected. However, no primary could be found. Autopsy revealed an osteosarcoma in the region of the hip joint with alternating formation of tumor cartilage and tumor bone. There were also undifferentiated portions of "endocrine osteosarcoma," simulating carcinoma. In spite of extensive skeletal involvement and pulmonary metastases--and high age--no evidence of morbus Paget of bone as possible preneoplastic disease was found.

Bone Neoplasms↗