Clinicopathological and Radiological Correlation in Osteosarcoma: A Prospective Study of 91 Cases

Osteosarcoma is the most common primary malignant bone tumor, primarily affecting adolescents during rapid bone growth.

A prospective study of 91 cases of osteosarcoma diagnosed at Gujarat Cancer and Research Institute, Ahmedabad (2014-2016). Clinical history, radiological imaging (X-ray, CT, MRI), and histopathological findings (H&E staining) were analyzed. Correlation with radiological features such as cortical breach, periosteal reaction, and soft tissue extension was evaluated.

Peak incidence: Second decade (60.4%), with a male-to-female ratio of 1.6:1. Common sites: Distal femur (39.6%), proximal tibia (30.7%), and proximal humerus (9.9%). Histopathological subtypes: Osteoblastic (44%), chondroblastic (22%), fibroblastic (11%), MFH-type (8.8%), giant cell-rich (4.4%), telangiectatic (4.4%), parosteal (3.3%), and small cell (2.1%). Radiological accuracy: Parosteal (100%) and small cell (100%) had the highest radiological correlation, while giant cell-rich osteosarcoma (25%) was frequently misdiagnosed. Cortical breach and periosteal reaction were observed in 92.6% of cases.

Osteosarcoma predominantly affects adolescents, with metaphyseal long bone involvement. Radiology aids in primary diagnosis but lacks subtype specificity. Histopathology remains the gold standard, necessitating a multidisciplinary approach for precise diagnosis and management.