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Related Experiment Video

Updated: May 20, 2026

Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models
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Low-grade central osteosarcoma: a difficult condition to diagnose.

A M Malhas1, V P Sumathi, S L James

  • 1The Royal Orthopaedic Hospital Oncology Service, Royal Orthopaedic Hospital, Bristol Road South, Birmingham B31 2AP, UK.

Sarcoma
|August 2, 2012
PubMed
Summary

Low-grade central osteosarcoma (LGCO) is challenging to diagnose, often leading to delayed treatment and recurrence. Early referral to specialist centers improves diagnostic accuracy and patient outcomes for this rare bone cancer.

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Area of Science:

  • Oncology
  • Orthopedic Surgery
  • Pathology

Background:

  • Low-grade central osteosarcoma (LGCO) is a rare osteosarcoma variant with diagnostic challenges.
  • Delayed or incorrect diagnosis can lead to higher-grade recurrence and suboptimal treatment.
  • Accurate diagnosis is crucial as LGCO management differs significantly from benign bone lesions.

Purpose of the Study:

  • To review institutional experience with LGCO.
  • To identify factors influencing diagnosis and patient outcomes.
  • To emphasize the importance of timely and accurate diagnosis.

Main Methods:

  • Retrospective review of 18 LGCO cases over 25 years from 1540 osteosarcoma cases (1.2%).
  • Analysis of referral patterns, diagnostic processes (including biopsies), treatment modalities, and patient outcomes.

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  • Evaluation of survivorship and recurrence rates.

    • Main Results:

    • Only 61% of LGCO cases were direct primary referrals; 40% presented with recurrence after initial misdiagnosis elsewhere.
    • Initial biopsies were diagnostic in only 55% of primary cases, with up to three biopsies needed in some instances.
    • Five-year overall survivorship was 90%, with 17 patients undergoing limb salvage and one amputation.

    Conclusions:

    • LGCO diagnosis is challenging due to nonspecific radiological and histological features.
    • Prompt referral of solitary bone lesions with difficult or nondiagnostic biopsies to specialist tumor units is essential.
    • Timely and accurate diagnosis significantly impacts treatment decisions and patient prognosis.