Many faces of osteosarcoma on plain radiographs.

Area of Science:

• Oncology
• Radiology
• Surgical Pathology

Background:

• Osteosarcoma is the most frequent primary bone cancer.
• It is exceptionally rare, with an incidence of 3 per million annually.
• This rarity means many surgeons encounter few cases, complicating diagnosis.

Purpose of the Study:

• To illustrate the varied imaging characteristics of osteosarcoma subtypes.
• To aid surgeons in diagnosing this rare bone cancer.
• To correlate imaging findings with different osteosarcoma presentations.

Main Methods:

• Review of imaging studies (radiographs, CT, MRI) of confirmed osteosarcoma cases.
• Categorization of imaging findings based on lesion density (sclerotic, lytic, cystic).
• Documentation of tumor location (medullary, cortical, periosteal).

Main Results:

• Demonstration of diverse imaging phenotypes, from dense sclerotic to purely lytic or cystic lesions.
• Examples of intramedullary, cortical, and periosteal-based osteosarcomas shown.
• Correlation between specific imaging appearances and osteosarcoma subtypes.

Conclusions:

• The wide spectrum of osteosarcoma imaging appearances necessitates broad recognition.
• Familiarity with these diverse presentations improves diagnostic accuracy for surgeons.
• This visual guide supports the timely identification of osteosarcoma.