Osteosarcoma - Revision history

Michael at 19:59, 12 June 2014

2014-06-12T19:59:50Z

← Older revision		Revision as of 19:59, 12 June 2014
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	\| Micro = cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid		\| Micro = cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid
	\| Subtypes = conventional osteosarcoma (osteoblastic osteosarcoma, [[fibroblastic osteosarcoma]], [[chondroblastic osteosarcoma]]), [[small cell osteosarcoma]], [[telangiectatic osteosarcoma]], [[parosteal osteosarcoma]], periosteal osteosarcoma, [[low-grade central osteosarcoma]], high-grade surface osteosarcoma, [[secondary osteosarcoma]], gnathic osteosarcoma		\| Subtypes = conventional osteosarcoma (osteoblastic osteosarcoma, [[fibroblastic osteosarcoma]], [[chondroblastic osteosarcoma]]), [[small cell osteosarcoma]], [[telangiectatic osteosarcoma]], [[parosteal osteosarcoma]], periosteal osteosarcoma, [[low-grade central osteosarcoma]], high-grade surface osteosarcoma, [[secondary osteosarcoma]], gnathic osteosarcoma
	\| LMDDx = [[chondrosarcoma]]		\| LMDDx = [[chondrosarcoma]], [[phosphaturic mesenchymal tumour, mixed connective tissue type]], [[undifferentiated pleomorphic sarcoma]] (for fibroblastic osteosarcoma), [[aneurysmal bone cyst]] (for telangiectatic osteosarcoma), [[fibrous dysplasia]], [[small round cell tumours]] (for small cell osteosarcoma)
	\| Stains =		\| Stains =
	\| IHC =		\| IHC =

Michael: /* Microscopic */

2014-06-12T19:57:20Z

Microscopic

← Older revision		Revision as of 19:57, 12 June 2014
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	**Osteoid on H&E: pink, homogenous, "glassy".		**Osteoid on H&E: pink, homogenous, "glassy".
	**Tumours typically very cellular - when compared to normal bone.		**Tumours typically very cellular - when compared to normal bone.
	*Large (multinucleated) osteoclast-like giant cells ~~may be seen~~.<ref>{{cite journal \|author=Papalas JA, Balmer NN, Wallace C, Sangueeza OP \|title=Ossifying dermatofibroma with osteoclast-like giant cells: report of a case and literature review \|journal=Am J Dermatopathol \|volume=31 \|issue=4 \|pages=379-83 \|year=2009 \|month=June \|pmid=19461244 \|doi=10.1097/DAD.0b013e3181966747 \|url=}}</ref>		*+/-Large (multinucleated) osteoclast-like giant cells.<ref>{{cite journal \|author=Papalas JA, Balmer NN, Wallace C, Sangueeza OP \|title=Ossifying dermatofibroma with osteoclast-like giant cells: report of a case and literature review \|journal=Am J Dermatopathol \|volume=31 \|issue=4 \|pages=379-83 \|year=2009 \|month=June \|pmid=19461244 \|doi=10.1097/DAD.0b013e3181966747 \|url=}}</ref>

			DDx:
			*[[Chondrosarcoma]].
			*[[Phosphaturic mesenchymal tumour, mixed connective tissue type]].
			*Others.

	====Images====		====Images====

Michael: redirect

2013-08-25T12:21:25Z

redirect

← Older revision		Revision as of 12:21, 25 August 2013
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	\| Site = [[bone]]		\| Site = [[bone]]
	\| Assdx =		\| Assdx =
	\| Syndromes =		\| Syndromes = [[Li-Fraumeni syndrome]]
	\| Clinicalhx =		\| Clinicalhx =
	\| Signs =		\| Signs =

Michael: tweak

2013-08-25T11:37:06Z

tweak

← Older revision		Revision as of 11:37, 25 August 2013
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	\| ClinDDx = [[aneurysmal bone cyst]],[[fibrous dysplasia]], [[Ewing sarcoma]]		\| ClinDDx = [[aneurysmal bone cyst]],[[fibrous dysplasia]], [[Ewing sarcoma]]
	}}		}}
	'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].		'''Osteosarcoma''', also known as '''osteogenic sarcoma''', is a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].

	==General==		==General==

Michael: tweak

2013-08-24T20:06:18Z

tweak

← Older revision		Revision as of 20:06, 24 August 2013
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	\| Caption = Osteosarcoma. [[H&E stain]].		\| Caption = Osteosarcoma. [[H&E stain]].
	\| Micro = cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid		\| Micro = cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid
	\| Subtypes = conventional osteosarcoma (osteoblastic osteosarcoma, [[fibroblastic osteosarcoma]], [[chondroblastic osteosarcoma]]), small cell osteosarcoma, [[telangiectatic osteosarcoma]], [[parosteal osteosarcoma]], periosteal osteosarcoma, [[low-grade central osteosarcoma]], high-grade surface osteosarcoma,		\| Subtypes = conventional osteosarcoma (osteoblastic osteosarcoma, [[fibroblastic osteosarcoma]], [[chondroblastic osteosarcoma]]), [[small cell osteosarcoma]], [[telangiectatic osteosarcoma]], [[parosteal osteosarcoma]], periosteal osteosarcoma, [[low-grade central osteosarcoma]], high-grade surface osteosarcoma, [[secondary osteosarcoma]], gnathic osteosarcoma
	[[secondary osteosarcoma]], gnathic osteosarcoma
	\| LMDDx = [[chondrosarcoma]]		\| LMDDx = [[chondrosarcoma]]
	\| Stains =		\| Stains =

Michael at 20:01, 24 August 2013

2013-08-24T20:01:55Z

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	\| Signs =		\| Signs =
	\| Symptoms =		\| Symptoms =
	\| Prevalence =		\| Prevalence = uncommon
	\| Bloodwork =		\| Bloodwork =
	\| Rads =		\| Rads =

Michael at 20:01, 24 August 2013

2013-08-24T20:01:12Z

← Older revision		Revision as of 20:01, 24 August 2013
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	\| Prognosis =		\| Prognosis =
	\| Other =		\| Other =
	\| ClinDDx = [[aneurysmal bone cyst]],[[fibrous dysplasia]]		\| ClinDDx = [[aneurysmal bone cyst]],[[fibrous dysplasia]], [[Ewing sarcoma]]
	}}		}}
	'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].		'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].

Michael: /* Images */ tweak

2013-08-24T20:00:19Z

Images: tweak

← Older revision		Revision as of 20:00, 24 August 2013
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	====Images====		====Images====
	<gallery>		<gallery>
			Image:Osteosarcoma - low mag.jpg\|Osteosarcoma - low mag. (WC)
	Image:Osteosarcoma_-_intermed_mag.jpg \| Osteosarcoma - intermed. mag. (WC)		Image:Osteosarcoma_-_intermed_mag.jpg \| Osteosarcoma - intermed. mag. (WC)
			Image: Osteosarcoma - high mag.jpg\|Osteosarcoma - high mag. (WC)
	Image:Osteosarcoma_-_very_high_mag.jpg \| Osteosarcoma - very high mag. (WC)		Image:Osteosarcoma_-_very_high_mag.jpg \| Osteosarcoma - very high mag. (WC)
	Image:Small_cell_osteosarcoma_-_intermed_mag.jpg \| Small cell osteosarcoma - intermed. mag. (WC)		Image:Small_cell_osteosarcoma_-_intermed_mag.jpg \| Small cell osteosarcoma - intermed. mag. (WC)

Michael: +infobox

2013-08-24T19:56:17Z

+infobox

← Older revision		Revision as of 19:56, 24 August 2013
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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image = Osteosarcoma_-_very_high_mag.jpg
			\| Width =
			\| Caption = Osteosarcoma. [[H&E stain]].
			\| Micro = cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid
			\| Subtypes = conventional osteosarcoma (osteoblastic osteosarcoma, [[fibroblastic osteosarcoma]], [[chondroblastic osteosarcoma]]), small cell osteosarcoma, [[telangiectatic osteosarcoma]], [[parosteal osteosarcoma]], periosteal osteosarcoma, [[low-grade central osteosarcoma]], high-grade surface osteosarcoma,
			[[secondary osteosarcoma]], gnathic osteosarcoma
			\| LMDDx = [[chondrosarcoma]]
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing =
			\| Site = [[bone]]
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence =
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis =
			\| Other =
			\| ClinDDx = [[aneurysmal bone cyst]],[[fibrous dysplasia]]
			}}
	'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].		'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].

Michael: re-work

2013-08-24T19:50:37Z

re-work

← Older revision		Revision as of 19:50, 24 August 2013
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	'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour.		'''Osteosarcoma''', also known as '''osteogenic sarcoma''', a malignant [[bone]] tumour. It is grouped with the [[chondro-osseous tumours]].

	===General===		==General==
	*Most common malignant bone tumour in children.		*Most common malignant bone tumour in children.
	*May be seen in the context of [[Li-Fraumeni syndrome]].		*May be seen in the context of [[Li-Fraumeni syndrome]].
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	*Terry Fox was afflicited by this tumour.		*Terry Fox was afflicited by this tumour.

	====Definition====		===Definition===
	*Tumour that makes osteoid.		*Tumour that makes osteoid.
	**Osteoid = (extracellular) organic component of bone, normally produced by osteoblasts (cells which make bone matrix).		**Osteoid = (extracellular) organic component of bone, normally produced by osteoblasts (cells which make bone matrix).

	===Gross===		==Gross==
	Classic locations:<ref name=Ref_TN2007_OR43>{{Ref TN2007\|OR43}}</ref>		Classic locations:<ref name=Ref_TN2007_OR43>{{Ref TN2007\|OR43}}</ref>
	*Distal femur ~ 45%.		*Distal femur ~ 45%.
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	*Proximal humerous ~ 15%.		*Proximal humerous ~ 15%.

	===Microscopic===		==Microscopic==
	Features:		Features:
	*Cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid.		*Cells with malignant features (e.g. nuclear membrane irregularities, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid.
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	*Large (multinucleated) osteoclast-like giant cells may be seen.<ref>{{cite journal \|author=Papalas JA, Balmer NN, Wallace C, Sangueeza OP \|title=Ossifying dermatofibroma with osteoclast-like giant cells: report of a case and literature review \|journal=Am J Dermatopathol \|volume=31 \|issue=4 \|pages=379-83 \|year=2009 \|month=June \|pmid=19461244 \|doi=10.1097/DAD.0b013e3181966747 \|url=}}</ref>		*Large (multinucleated) osteoclast-like giant cells may be seen.<ref>{{cite journal \|author=Papalas JA, Balmer NN, Wallace C, Sangueeza OP \|title=Ossifying dermatofibroma with osteoclast-like giant cells: report of a case and literature review \|journal=Am J Dermatopathol \|volume=31 \|issue=4 \|pages=379-83 \|year=2009 \|month=June \|pmid=19461244 \|doi=10.1097/DAD.0b013e3181966747 \|url=}}</ref>

	=====Images=====		====Images====
	<gallery>		<gallery>
	Image:Osteosarcoma_-_intermed_mag.jpg \| Osteosarcoma - intermed. mag. (WC)		Image:Osteosarcoma_-_intermed_mag.jpg \| Osteosarcoma - intermed. mag. (WC)
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	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2843711/figure/F3/ Lace-like osteoid of osteosarcoma (nih.gov)].<ref name=pmid20181254>{{Cite journal \| last1 = Papandreou \| first1 = C. \| last2 = Skopelitou \| first2 = A. \| last3 = Kappes \| first3 = G. \| last4 = Daouaher \| first4 = H. \| title = Primary osteosarcoma of the urinary bladder treated with external radiotherapy in a patient with a history of transitional cell carcinoma: a case report. \| journal = J Med Case Rep \| volume = 4 \| issue = \| pages = 70 \| month = \| year = 2010 \| doi = 10.1186/1752-1947-4-70 \| PMID = 20181254 \| PMC = 2843711 }}</ref>		*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2843711/figure/F3/ Lace-like osteoid of osteosarcoma (nih.gov)].<ref name=pmid20181254>{{Cite journal \| last1 = Papandreou \| first1 = C. \| last2 = Skopelitou \| first2 = A. \| last3 = Kappes \| first3 = G. \| last4 = Daouaher \| first4 = H. \| title = Primary osteosarcoma of the urinary bladder treated with external radiotherapy in a patient with a history of transitional cell carcinoma: a case report. \| journal = J Med Case Rep \| volume = 4 \| issue = \| pages = 70 \| month = \| year = 2010 \| doi = 10.1186/1752-1947-4-70 \| PMID = 20181254 \| PMC = 2843711 }}</ref>

	====Subtypes====		===Subtypes===
	Subtypes:<ref name=Ref_WMSP638>{{Ref WMSP\|638}}</ref><ref>URL: [http://bestpractice.bmj.com/best-practice/monograph/780/basics/classification.html http://bestpractice.bmj.com/best-practice/monograph/780/basics/classification.html]. Accessed on: 7 April 2011.</ref>		Subtypes:<ref name=Ref_WMSP638>{{Ref WMSP\|638}}</ref><ref>URL: [http://bestpractice.bmj.com/best-practice/monograph/780/basics/classification.html http://bestpractice.bmj.com/best-practice/monograph/780/basics/classification.html]. Accessed on: 7 April 2011.</ref>
	*Conventional osteosarcoma (high grade).		*Conventional osteosarcoma (high grade).
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	*Telangiectatic.		*Telangiectatic.

	=====Chondroblastic osteosarcoma=====		====Chondroblastic osteosarcoma====
	*Chondroid matrix present - may be prominent; osteoid may be a minor component.		*Chondroid matrix present - may be prominent; osteoid may be a minor component.
	*May be confused with [[chondrosarcoma]].		*May be confused with [[chondrosarcoma]].

	=====Fibroblastic osteosarcoma=====		====Fibroblastic osteosarcoma====
	*[[Undifferentiated pleomorphic sarcoma]]-like/[[MFH]]-like.		*[[Undifferentiated pleomorphic sarcoma]]-like/[[MFH]]-like.

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	*[http://path.upmc.edu/cases/case44.html Fibroblastic osteosarcoma (upmc.edu)].		*[http://path.upmc.edu/cases/case44.html Fibroblastic osteosarcoma (upmc.edu)].

	=====Low-grade central osteosarcoma=====		====Low-grade central osteosarcoma====
	*Well-formed bone.		*Well-formed bone.
	*Usu. minimal nuclear atypia.		*Usu. minimal nuclear atypia.
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	*[[Fibrous dysplasia]].<ref name=inwards>{{cite journal \|author=Inwards, CY \|title=Low-grade central osteosarcoma versus fibrous dysplasia \|journal=Pathology Case Reviews \|volume=6 \|issue=1 \|pages=22-27 \|year=2001 \|pmid= \|doi= \|url= http://journals.lww.com/pathologycasereviews/Fulltext/2001/01000/Low_Grade_Central_Osteosarcoma_Versus_Fibrous.5.aspx }}</ref>		*[[Fibrous dysplasia]].<ref name=inwards>{{cite journal \|author=Inwards, CY \|title=Low-grade central osteosarcoma versus fibrous dysplasia \|journal=Pathology Case Reviews \|volume=6 \|issue=1 \|pages=22-27 \|year=2001 \|pmid= \|doi= \|url= http://journals.lww.com/pathologycasereviews/Fulltext/2001/01000/Low_Grade_Central_Osteosarcoma_Versus_Fibrous.5.aspx }}</ref>

	=====Telangiectatic osteosarcoma=====		====Telangiectatic osteosarcoma====
	*Rare.<ref name=omim21339678>{{Cite journal \| last1 = Patibandla \| first1 = MR. \| last2 = Uppin \| first2 = SG. \| last3 = Thotakura \| first3 = AK. \| last4 = Panigrahi \| first4 = MK. \| last5 = Challa \| first5 = S. \| title = Primary telangiectatic osteosarcoma of occipital bone: a case report and review of literature. \| journal = Neurol India \| volume = 59 \| issue = 1 \| pages = 117-9 \| month = \| year = \| doi = 10.4103/0028-3886.76891 \| PMID = 21339678 }}</ref>		*Rare.<ref name=omim21339678>{{Cite journal \| last1 = Patibandla \| first1 = MR. \| last2 = Uppin \| first2 = SG. \| last3 = Thotakura \| first3 = AK. \| last4 = Panigrahi \| first4 = MK. \| last5 = Challa \| first5 = S. \| title = Primary telangiectatic osteosarcoma of occipital bone: a case report and review of literature. \| journal = Neurol India \| volume = 59 \| issue = 1 \| pages = 117-9 \| month = \| year = \| doi = 10.4103/0028-3886.76891 \| PMID = 21339678 }}</ref>
	*Extremely vascular.		*Extremely vascular.
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	*[[Aneurysmal bone cyst]].		*[[Aneurysmal bone cyst]].

	=====Parosteal osteosarcoma=====		====Parosteal osteosarcoma====
	*Arise from surface of bone.<ref>{{Ref WHOSTAB\|279}}</ref>		*Arise from surface of bone.<ref>{{Ref WHOSTAB\|279}}</ref>
	*Low grade.<ref name=pmid16896870>{{Cite journal \| last1 = Carrle \| first1 = D. \| last2 = Bielack \| first2 = SS. \| title = Current strategies of chemotherapy in osteosarcoma. \| journal = Int Orthop \| volume = 30 \| issue = 6 \| pages = 445-51 \| month = Dec \| year = 2006 \| doi = 10.1007/s00264-006-0192-x \| PMID = 16896870 \| PMC = 3172747 \| URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172747/?tool=pubmed}}</ref>		*Low grade.<ref name=pmid16896870>{{Cite journal \| last1 = Carrle \| first1 = D. \| last2 = Bielack \| first2 = SS. \| title = Current strategies of chemotherapy in osteosarcoma. \| journal = Int Orthop \| volume = 30 \| issue = 6 \| pages = 445-51 \| month = Dec \| year = 2006 \| doi = 10.1007/s00264-006-0192-x \| PMID = 16896870 \| PMC = 3172747 \| URL = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3172747/?tool=pubmed}}</ref>
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	*[[Fibrous dysplasia]].{{fact}}		*[[Fibrous dysplasia]].{{fact}}

	=====Periosteal osteosarcoma=====		====Periosteal osteosarcoma====
	*Intermediate grade.<ref name=pmid16896870/>		*Intermediate grade.<ref name=pmid16896870/>

	=====Small cell osteosarcoma=====		====Small cell osteosarcoma====
	*May mimic (other) [[small round cell tumours]].		*May mimic (other) [[small round cell tumours]].

	=====Secondary osteosarcoma=====		====Secondary osteosarcoma====
	Arises in the context of something else - causes:		Arises in the context of something else - causes:
	*[[Paget disease of the bone]] (~80% of secondary osteosarcomas)		*[[Paget disease of the bone]] (~80% of secondary osteosarcomas)