Endobronchial metastasis from extrapulmonary carcinoma, both clinically and radiologically similar in appearance to a primary lung cancer, is rare. We present a case of endobronchial metastasis from parosteal osteosarcoma. The first abnormality noted on the chest radiography was tramline calcification with branching pattern along the right upper lobe bronchus and intermediate bronchus. This lesion progressed into a solid calcified nodule which increased in size. Another lesion with same pattern was also observed in the left lower lung zone.
Bronchi ; Lung ; Lung Neoplasms ; Neoplasm Metastasis ; Osteosarcoma* ; Radiography ; Thorax

Periosteal osteosarcoma is an extremely rare chondroblastic osteosarcoma in the flat bone. There were authors reporting of two cases of periosteal osteosarcoma in the highly unusual sites. One of them arose from the rib, in a 17-year-old male, which appeared as a hypodense juxtacortical mass with periosteal reaction on CT. The other one arose from the scapula, in a 17-year-old female, which showed the intermediate signal intensity (SI) on T1-weighted image (WI), heterogeneous high SI on T2WI, and rim-enhancement on contrast-enhanced T1WI with cortical destruction on MRI.
Adolescent ; Bone Neoplasms/*radiography ; Contrast Media/diagnostic use ; Female ; Humans ; Male ; Osteosarcoma/*radiography ; Ribs/*radiography ; Scapula/*radiography

Fibrocartilaginous dysplasia (FCD) has occasionally led to a misdiagnosis and wrong decision which can significantly alter the outcome of the patients. A 9-yr-old boy presented with pain on his left distal thigh for 6 months without any trauma history. Initial radiographs showed moth eaten both osteolytic and osteosclerotic lesions and biopsy findings showed that the lesion revealed many irregular shaped and sclerotic mature and immature bony trabeculae. Initial diagnostic suggestions were varied from the conventional osteosarcoma to low grade central osteosarcoma or benign intramedullary bone forming lesion, but close observation was done. This study demonstrated a case of unusual fibrocartilaginous intramedullary bone forming tumor mimicking osteosarcoma, so that possible misdiagnosis might be made and unnecessary extensive surgical treatment could be performed. In conclusion, the role of orthopaedic oncologist as a decision maker is very important when the diagnosis is uncertain.
Bone and Bones/*radiography ; Child ; Diagnosis, Differential ; Femur/radiography ; Fibrocartilage/*radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Osteosarcoma/diagnosis/radiography

Parosteal osteosarcoma is a low-grade osteosarcoma, which occurs on the surface of the bone. We had experienced a parosteal osteosarcoma involving the flat bone, the scapula of a 21-year-old man. This is an extremely rare location for a parosteal osteosarcoma. Plain radiograph showed broad-based, well-defined radiodense lesion at the scapula. Computed tomogram demonstrated an intact cortex and absence of a medullary involvement. Tumor showed a lobulated, high-density lesion, indicating bone formation. Histologically, parosteal osteosarcoma is a well-differentiated osteosarcoma. The tumor is composed of a hypocellular proliferation of spindle cells, with minimal cytologic atypia. The bone is in the form of a well-formed bony trabeculae. Occasional cartilage is present in the form of a cap.
Adult ; Bone Neoplasms/radiography* ; Bone Neoplasms/pathology ; Case Report ; Human ; Male ; Osteosarcoma/radiography* ; Osteosarcoma/pathology ; Scapula/radiography* ; Scapula/pathology ; Tomography, X-Ray Computed

Parosteal osteosarcoma is a low-grade osteosarcoma, which occurs on the surface of the bone. We had experienced a parosteal osteosarcoma involving the flat bone, the scapula of a 21-year-old man. This is an extremely rare location for a parosteal osteosarcoma. Plain radiograph showed broad-based, well-defined radiodense lesion at the scapula. Computed tomogram demonstrated an intact cortex and absence of a medullary involvement. Tumor showed a lobulated, high-density lesion, indicating bone formation. Histologically, parosteal osteosarcoma is a well-differentiated osteosarcoma. The tumor is composed of a hypocellular proliferation of spindle cells, with minimal cytologic atypia. The bone is in the form of a well-formed bony trabeculae. Occasional cartilage is present in the form of a cap.
Adult ; Bone Neoplasms/radiography* ; Bone Neoplasms/pathology ; Case Report ; Human ; Male ; Osteosarcoma/radiography* ; Osteosarcoma/pathology ; Scapula/radiography* ; Scapula/pathology ; Tomography, X-Ray Computed

Malignant mesenchymoma is an interesting but very rare tumor in which malignant differentiation has occurred twice or more. We report a case of retroperitoneal malignant mesenchymoma consisting of osteosarcoma, leiomyosarcoma, liposarcoma and fibrosarcoma. Abdominal CT showed a large retroperitoneal mass with two separate and distinct parts, namely an area of prominent calcification and one of clearly enhancing solid components. The mass contained histologically distinct tumorous components with no histologic admixure at the interfaces. The densely calcified nodule corresponded to osteosarcoma, and the noncalcified clearly enhancing nodules to leiomyosarcoma, liposarcoma and fibrosarcoma.
Case Report ; Fibrosarcoma/*radiography ; Human ; Leiomyosarcoma/*radiography ; Liposarcoma/*radiography ; Male ; Mesenchymoma/*radiography ; Middle Age ; Osteosarcoma/*radiography ; Retroperitoneal Neoplasms/*radiography ; Tomography, X-Ray Computed

Fibrous dysplasia is a skeletal developmental anomaly of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a nonhereditary disorder of unknown cause. In fibrous dysplasia, the medullary bone is replaced by fibrous tissue, which appears various imaging findings. It is usually an incidental finding, generally not requiring further investigation. However, fibrous dysplasia may be complicated by pathologic fracture, and rarely by malignant degeneration. We present the image findings of a 44-year-old man who had a chondroblastic osteosarcoma arising from polyostotic fibrous dysplasia in the femur. Evidence of cortical destruction on plain radiography and soft tissue mass in the lesion on MR images suggested a tumor of malignant transformation.
Adult ; Chondrocytes ; Femur ; Fibrous Dysplasia, Polyostotic* ; Fractures, Spontaneous ; Humans ; Incidental Findings ; Mesoderm ; Osteoblasts ; Osteosarcoma* ; Radiography

Osteosarcoma is the most common primary bone tumor after plasma cell neoplasms. Osteosarcoma has diverse histological features and is characterized by the presence of malignant spindle cells and pluripotent neoplastic mesenchymal cells that produce immature bone, cartilage, and fibrous tissue. Osteosarcoma most frequently develops in the extremities of long bones, but can occur in the jaw in rare cases. The clinical and biological behavior of osteosarcoma of the jaw slightly differs from that of long-bone osteosarcoma. The incidence of jaw osteosarcoma is greater in the third to fourth decades of life, whereas long-bone osteosarcoma mostly occurs in the second decade of life. Osteosarcoma of the jaw has a lower tendency to metastasize and a better prognosis than long-bone osteosarcoma. Radiographically, osteosarcoma can present as a poorly-defined lytic, sclerotic, or mixed-density lesion with periosteal bone reaction response. Multi-detector computed tomography is useful for identifying the extent of bone destruction, as well as soft tissue involvement of the lesion. The current case report presents a fibroblastic osteosarcoma involving the left hemimandible with very unusual radiographic features.
Cartilage ; Extremities ; Fibroblasts ; Incidence ; Jaw ; Neoplasms, Plasma Cell ; Osteosarcoma ; Prognosis ; Radiography

PURPOSE: The volumetric change of osteosarcoma after preoperative adjuvant chemotherapy is a significant prognostic factor. It is absolutely necessary that all volumetric measurements must be based on acceptable reproducibility. The purpose of this study was to investigate intra- and inter-observer variability of volumetric measurements, including plain radiography and magnetic resonance image (MRI). MATERIALS AND METHODS: Forty-one patients with osteosarcoma of the limb were included in this study. All patients underwent plain radiographs and MRIs before and after preoperative adjuvant chemotherapy (intraarterial Cisplatin and intravenous Adriamycin, 3 cycles). Volume measurement, using ellipsoid formula from maximal length, width and depth of the tumor on plain radiograph and MRI, were calculated. Three dimensional summation of the tumor volume from MRI, with digitized scanner and software (MatLab. MatWork Inc, Natick, MA, USA) was also performed. Coefficient of variation (CV) of each method was compared. RESULTS: CVs for intra- and inter-observer variability in plain radiograph using ellipsoid formula were 9.4% and 11.7% in prechemotherapy and 8.1% and 9.3% in post chemotherapy. CVs for intra- and inter-observer variability in MRI using ellipsoid formula were 7.3% and 7.9% in prechemotherapy, and 7.6% and 8.2% in postchemotherapy in T1 weighted image (T1WI) , 6.7% and 7.1% in prechemotherapy and 6.5% and 7.6% in postchemotherapy in T2 weighted image (T2WI), and 7.8% and 8.5% in prechemotherapy and 8.2% and 8.7% in postchemotherapy in Gd-DTPA enhanced image (GdEI) . CVs for intra- and inter-observer variability in MRI using three dimensional summation of tumor volume were 2.4% and 3.2% in prechemotherpay and 2.7% and 3.4% in postchemotherapy in T1WI, 1.2% and 1.4% in prechemotherapy and 1.3% and 1.4% in postchemotherapy in T2WI, and 3.8% and 4.5% in prechemotherapy and 3.1% and 4.6% in postchemotherapy in GdEI. CONCLUSION: There was higher reproducibility, that is lower CV, in three dimensional summation of tumor volume in T2WI. The statistically significant volume change after chemotherapy was 4.2% decrease or increase in volume compared with its original tumor volume in T2WI.
Chemotherapy, Adjuvant ; Cisplatin ; Doxorubicin ; Drug Therapy ; Extremities ; Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging* ; Observer Variation ; Osteosarcoma* ; Radiography ; Tumor Burden

BACKGROUND: We assessed the plain radiographic characteristics of 10 cases of osteosarcomas during the initial painful period that had been overlooked by a primary physician. In addition, we evaluated chronologic changes in radiographic findings from initial symptomatic period to the time of accurate diagnosis. METHODS: The clinical records were reviewed for clinical parameters including age, sex, location, presenting symptoms, initial diagnosis, duration from initial symptoms to definite diagnosis, and initial and follow-up plain radiographic findings of the lesion. RESULTS: Initial clinical diagnoses included a sprain in 6, growing pain in 2, stress fracture in 1, and infection in 1 patient. Initial plain radiographic findings were trabecular destruction (100%), cortical disruption (60%), periosteal reaction (60%), and soft tissue mass (10%). Intramedullary matrix changes were osteosclerosis in 6 and osteolysis in 4 patients. On progression, 4 cases with minimal sclerosis changed to osteoblastic lesion in 3 patients and osteolytic lesion in 1. Four cases with faint osteolytic foci transformed into osteolytic lesion in 3 and mixed pattern in 1. CONCLUSIONS: Notable plain radiologic findings of incipient-stage osteosarcoma include trabecular disruption along with faint osteosclerosis or osteolysis. In symptomatic patients with trabecular destruction, additional imaging study including magnetic resonance imaging should be performed to exclude osteosarcoma in the incipient phase, even without radiologic findings suggesting malignant tumor, such as cortical destruction or periosteal reaction.
Adolescent ; Adult ; Age Factors ; Bone Neoplasms/diagnosis/*radiography ; *Diagnostic Errors ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Osteosarcoma/diagnosis/*radiography ; Retrospective Studies ; Young Adult