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Rosette-forming epithelioid osteosarcoma: a histologic subtype with highly aggressive clinical behavior.
K Okada1, T Hasegawa, R Yokoyama
1Department of Orthopaedics, Akita University School of Medicine, Akita, Japan.
Human Pathology
|August 4, 2001
Summary
Osteosarcoma with gland-like rosettes is aggressive. This rare pattern in long bone osteosarcoma indicates a poor prognosis, with significantly lower survival rates than conventional types.
Area of Science:
- Oncology
- Pathology
- Skeletal Tumors
Background:
- Osteosarcoma exhibits diverse histologic patterns, with rare epithelioid presentations mimicking glandular structures.
- Rosette formation in osteosarcoma is an uncommon finding that may impact prognosis.
Purpose of the Study:
- To investigate the clinical and pathologic features of osteosarcomas with rosettelike structures.
- To compare the survival outcomes of these tumors with conventional osteoblastic osteosarcoma.
Main Methods:
- Retrospective review of 16 osteosarcoma cases with rosettelike structures treated between 1972 and 1999.
- Analysis of patient demographics, tumor characteristics, treatment, and survival data.
- Histologic and immunohistochemical evaluation (epithelial membrane antigen).
Main Results:
- The 16 patients were predominantly young males; tumors arose in long bone metaphyses, presenting as destructive lesions.
- A 5-year survival rate of 15% was observed, significantly lower than the 55% rate for conventional osteoblastic osteosarcoma.
- Tumors showed multinodular growth, lacelike osteoid, hemangiopericytoma-like vasculature, and 63% showed epithelial membrane antigen positivity.
Conclusions:
- Rosette formation in long bone osteosarcoma is an ominous sign associated with poor prognosis.
- These tumors warrant distinction from conventional osteosarcomas due to their aggressive behavior.
- Early identification and potentially tailored treatment strategies are crucial for improving outcomes.