Definition
Intermediate grade chondroblastic osteosarcoma arising from surface of long bones
Epidemiology
Extremely rare
- 1% of all osteosarcomas
- 25% of surface osteosarcomas
Age 15-25
Location
Typically anterior proximal tibia
- diaphysis of major long bones
- humerus
Pathology
Intermediate juxtacortical chondroblastic osteosarcoma
- produces osteoid
- also produces chondroid matrix
X-ray
Diaphysis of tibia or femur
Sunburst / periosteal reaction
Cortical erosion
Management
Algorithm
Similar to central osteosarcoma
Role of chemotherapy unclear
Results
Grimer et al Eur J Cancer 2005
- 119 patients with periosteal osteosarcoma
- more common in femur than tibia
- 89% 5 year survival
- 83% 10 year survival
- local recurrence poor prognosis
- chemotherapy used in 2/3 of patients, but did not affect prognosis
- 33 patients with periosteal osteosarcoma
- chemotherapy used with higher grades
- 10 year survival with chemotherapy 86%
- 10 year survival without chemotherapy 83%