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Modeling Primary Bone Tumors and Bone Metastasis with Solid Tumor Graft Implantation into Bone

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Diagnostic challenges in low-grade central osteosarcoma.

Adyb A Khal^1,2,3, Hisaki Aiba^1,4, Alberto Righi⁵

¹III Clinica di Ortopedia e Traumatologia a prevalente indirizzo oncologico, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

The Bone & Joint Journal

|December 31, 2023

Summary

This summary is machine-generated.

Low-grade central osteosarcoma (LGCOS) diagnosis is challenging due to overlapping features. Accurate diagnosis via open biopsy and wide surgical excision are key for successful treatment and improved outcomes in LGCOS patients.

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Area of Science:

Orthopedic Oncology
Skeletal Radiology
Surgical Pathology

Background:

Low-grade central osteosarcoma (LGCOS) presents diagnostic challenges due to ambiguous radiological and pathological features.
Misdiagnosis can complicate treatment and affect patient outcomes.

Purpose of the Study:

To analyze clinical, radiological, and pathological features of LGCOS.
To evaluate diagnostic accuracy, treatment strategies, and oncological outcomes for LGCOS.

Main Methods:

Retrospective analysis of 49 LGCOS patients (Broder's grade 1-2) from 1985-2017.
Evaluation of imaging features, biopsy accuracy (needle vs. open), surgical treatment (en-bloc resection, curettage), and oncological outcomes.

Main Results:

71.4% of patients showed malignant features on imaging.
Open biopsy had higher diagnostic accuracy (91.3%) than needle biopsy (35.3%).
Wide surgical margins (95%) were achieved in en-bloc resections; positive margins correlated with local recurrence. Five-year OS was 89.3%, D-RFS was 85.7%.

Conclusions:

LGCOS diagnosis is difficult due to non-specific features and low biopsy accuracy.
Precise diagnosis and surgical excision with wide margins are crucial for successful LGCOS treatment.