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Osteosarcoma
Jeffrey S. Ross, MDKevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Osteogenic sarcoma (OGS)
              • Definitions

                • Sarcoma containing osteoid matrix produced directly by malignant cells

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Parsai S et al: Spine radiosurgery in adolescents and young adults: early outcomes and toxicity in patients with metastatic Ewing sarcoma and osteosarcoma. J Neurosurg Spine. 1-8, 2019
                                                2. Chen DJ et al: Lumbar spinal canal osteosarcoma: a case report. Medicine (Baltimore). 97(25):e11210, 2018
                                                3. Noor Khairiah AK et al: Lumbosacral osteosarcoma with dural spread, skip lesions and intravascular extension: a case report. Med J Malaysia. 73(2):116-8, 2018
                                                4. Shankar GM et al: The role of revision surgery and adjuvant therapy following subtotal resection of osteosarcoma of the spine: a systematic review with meta-analysis. J Neurosurg Spine. 27(1):97-104, 2017
                                                5. Zhou Z et al: Does rarity mean imparity? Biological characteristics of osteosarcoma cells originating from the spine. J Cancer Res Clin Oncol. 143(10):1959-69, 2017
                                                6. Dekutoski MB et al: Osteosarcoma of the spine: prognostic variables for local recurrence and overall survival, a multicenter ambispective study. J Neurosurg Spine. 25(1):59-68, 2016
                                                7. Groves ML et al: Epidemiologic, functional, and oncologic outcome analysis of spinal sarcomas treated surgically at a single institution over 10 years. Spine J. 15(1):110-4, 2014
                                                8. Sadek AR et al: Multiple spinal osteochondromata and osteosarcoma in a patient with Gorlin's syndrome. Clin Neurol Neurosurg. 118:5-8, 2014
                                                9. Smith JA et al: Locomotor biomechanics after total sacrectomy: a case report. Spine (Phila Pa 1976). 39(24):E1481-7, 2014
                                                10. Bhatia R et al: Osteosarcoma of the spine: dismal past, any hope for the future? Br J Neurosurg. 28(4):495-502, 2013
                                                11. Katonis P et al: Spinal osteosarcoma. Clin Med Insights Oncol. 7:199-208, 2013
                                                12. Lim JB et al: Primary osteosarcoma of the spine: a review of 10 cases. Acta Orthop Belg. 79(4):457-62, 2013
                                                13. Schiller MD et al: A case of intradural osteosarcoma of the spine. Spine J. 13(8):e55-8, 2013
                                                14. Zils K et al: Osteosarcoma of the mobile spine. Ann Oncol. 24(8):2190-5, 2013
                                                15. Sundaresan N et al: Primary malignant tumors of the spine. Orthop Clin North Am. 40(1):21-36, v, 2009
                                                16. Kelley SP et al: Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry. Eur Spine J. 16(3):405-9, 2007
                                                17. Ilaslan H et al: Primary vertebral osteosarcoma: imaging findings. Radiology. 230(3):697-702, 2004
                                                18. Brenner W et al: PET imaging of osteosarcoma. J Nucl Med. 44(6):930-42, 2003
                                                19. Aung L et al: Second malignant neoplasms in long-term survivors of osteosarcoma: Memorial Sloan-Kettering Cancer Center Experience. Cancer. 95(8):1728-34, 2002
                                                20. Bredella MA et al: Value of FDG positron emission tomography in conjunction with MR imaging for evaluating therapy response in patients with musculoskeletal sarcomas. AJR Am J Roentgenol. 179(5):1145-50, 2002
                                                21. Ozaki T et al: Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. Cancer. 94(4):1069-77, 2002
                                                22. Iwata A et al: Osteosarcoma as a second malignancy after treatment for neuroblastoma. Pediatr Hematol Oncol. 18(7):465-9, 2001
                                                23. Yamamoto T et al: Sacral radiculopathy secondary to multicentric osteosarcoma. Spine. 26(15):1729-32, 2001
                                                24. Bramwell VH: Osteosarcomas and other cancers of bone. Curr Opin Oncol. 12(4):330-6, 2000
                                                25. Vuillemin-Bodaghi V et al: Multifocal osteogenic sarcoma in Paget's disease. Skeletal Radiol. 29(6):349-53, 2000
                                                26. Unni KK: Osteosarcoma of bone. J Orthop Sci. 3(5):287-94, 1998
                                                27. Rosenberg ZS et al: Osteosarcoma: subtle, rare, and misleading plain film features. AJR Am J Roentgenol. 165(5):1209-14, 1995
                                                28. Tigani D et al: Vertebral osteosarcoma. Ital J Orthop Traumatol. 14(1):5-13, 1988
                                                29. Barwick KW et al: Primary osteogenic sarcoma of the vertebral column: a clinicopathologic correlation of ten patients. Cancer. 46(3):595-604, 1980
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Osteogenic sarcoma (OGS)
                                                            • Definitions

                                                              • Sarcoma containing osteoid matrix produced directly by malignant cells

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Parsai S et al: Spine radiosurgery in adolescents and young adults: early outcomes and toxicity in patients with metastatic Ewing sarcoma and osteosarcoma. J Neurosurg Spine. 1-8, 2019
                                                                                              2. Chen DJ et al: Lumbar spinal canal osteosarcoma: a case report. Medicine (Baltimore). 97(25):e11210, 2018
                                                                                              3. Noor Khairiah AK et al: Lumbosacral osteosarcoma with dural spread, skip lesions and intravascular extension: a case report. Med J Malaysia. 73(2):116-8, 2018
                                                                                              4. Shankar GM et al: The role of revision surgery and adjuvant therapy following subtotal resection of osteosarcoma of the spine: a systematic review with meta-analysis. J Neurosurg Spine. 27(1):97-104, 2017
                                                                                              5. Zhou Z et al: Does rarity mean imparity? Biological characteristics of osteosarcoma cells originating from the spine. J Cancer Res Clin Oncol. 143(10):1959-69, 2017
                                                                                              6. Dekutoski MB et al: Osteosarcoma of the spine: prognostic variables for local recurrence and overall survival, a multicenter ambispective study. J Neurosurg Spine. 25(1):59-68, 2016
                                                                                              7. Groves ML et al: Epidemiologic, functional, and oncologic outcome analysis of spinal sarcomas treated surgically at a single institution over 10 years. Spine J. 15(1):110-4, 2014
                                                                                              8. Sadek AR et al: Multiple spinal osteochondromata and osteosarcoma in a patient with Gorlin's syndrome. Clin Neurol Neurosurg. 118:5-8, 2014
                                                                                              9. Smith JA et al: Locomotor biomechanics after total sacrectomy: a case report. Spine (Phila Pa 1976). 39(24):E1481-7, 2014
                                                                                              10. Bhatia R et al: Osteosarcoma of the spine: dismal past, any hope for the future? Br J Neurosurg. 28(4):495-502, 2013
                                                                                              11. Katonis P et al: Spinal osteosarcoma. Clin Med Insights Oncol. 7:199-208, 2013
                                                                                              12. Lim JB et al: Primary osteosarcoma of the spine: a review of 10 cases. Acta Orthop Belg. 79(4):457-62, 2013
                                                                                              13. Schiller MD et al: A case of intradural osteosarcoma of the spine. Spine J. 13(8):e55-8, 2013
                                                                                              14. Zils K et al: Osteosarcoma of the mobile spine. Ann Oncol. 24(8):2190-5, 2013
                                                                                              15. Sundaresan N et al: Primary malignant tumors of the spine. Orthop Clin North Am. 40(1):21-36, v, 2009
                                                                                              16. Kelley SP et al: Primary bone tumours of the spine: a 42-year survey from the Leeds Regional Bone Tumour Registry. Eur Spine J. 16(3):405-9, 2007
                                                                                              17. Ilaslan H et al: Primary vertebral osteosarcoma: imaging findings. Radiology. 230(3):697-702, 2004
                                                                                              18. Brenner W et al: PET imaging of osteosarcoma. J Nucl Med. 44(6):930-42, 2003
                                                                                              19. Aung L et al: Second malignant neoplasms in long-term survivors of osteosarcoma: Memorial Sloan-Kettering Cancer Center Experience. Cancer. 95(8):1728-34, 2002
                                                                                              20. Bredella MA et al: Value of FDG positron emission tomography in conjunction with MR imaging for evaluating therapy response in patients with musculoskeletal sarcomas. AJR Am J Roentgenol. 179(5):1145-50, 2002
                                                                                              21. Ozaki T et al: Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group. Cancer. 94(4):1069-77, 2002
                                                                                              22. Iwata A et al: Osteosarcoma as a second malignancy after treatment for neuroblastoma. Pediatr Hematol Oncol. 18(7):465-9, 2001
                                                                                              23. Yamamoto T et al: Sacral radiculopathy secondary to multicentric osteosarcoma. Spine. 26(15):1729-32, 2001
                                                                                              24. Bramwell VH: Osteosarcomas and other cancers of bone. Curr Opin Oncol. 12(4):330-6, 2000
                                                                                              25. Vuillemin-Bodaghi V et al: Multifocal osteogenic sarcoma in Paget's disease. Skeletal Radiol. 29(6):349-53, 2000
                                                                                              26. Unni KK: Osteosarcoma of bone. J Orthop Sci. 3(5):287-94, 1998
                                                                                              27. Rosenberg ZS et al: Osteosarcoma: subtle, rare, and misleading plain film features. AJR Am J Roentgenol. 165(5):1209-14, 1995
                                                                                              28. Tigani D et al: Vertebral osteosarcoma. Ital J Orthop Traumatol. 14(1):5-13, 1988
                                                                                              29. Barwick KW et al: Primary osteogenic sarcoma of the vertebral column: a clinicopathologic correlation of ten patients. Cancer. 46(3):595-604, 1980