Original ContributionsRosette-forming epithelioid osteosarcoma: A histologic subtype with highly aggressive clinical behavior☆
Section snippets
Materials and methods
We selected and reviewed 16 cases of osteosarcoma with rosettelike structures, which accounted for 5.7% of 280 cases of osteosarcoma documented in files of the NCC Hospital, Tokyo, and the Akita University Hospital, Akita, Japan, from 1972 to 1999. The rosettelike structures were identified in pretreatment biopsy slides. Clinical details and follow-up information were obtained by reviewing all medical charts. Pretreatment radiographs were examined in 14 of the 16 cases. Computed tomography (CT)
Clinical features
Clinical data for each of the 16 patients are summarized in Table 1.Case Age (yr)/Sex Site Symptom Duration Surgery Chemotherapy* Local Recurrence LM LE Stage Follow-up† 1 15/F Tibia P, S 2 AKA + − + − IIB 14 mo, DOD 2 21/M Femur P 3 AKA +(<75) − + + IIB 28 mo, DOD 3 17/M Tibia P, S 2 AKA +(<75) − + − IIB 32 mo, DOD 4 8/M Femur P, S 1 AKA +(<50) − + + IIB 6 mo, DOD 5 12/M Femur P 3 None + + − IIB 5 mo, DOD‡ 6 13/M Femur P 2 AKA +(<50) − + − IIB 12 mo, DOD 7 14/M Femur P, S 1 Wide +(<75) − + − IIB 19 mo, DOD 8 21/F Femur
Discussion
We found that our 16 cases accounted for 5.7% of all osteosarcomas and consisted of multiple small nodules showing a rosette configuration with production of osteoid in the center bordered by blood vessels in a hemangiopericytoma-like pattern. The presence of rosettelike structures in osteosarcomas, although its exact incidence is unknown, has been noticed and illustrated by others.1, 5, 8, 9, 10 Nakajima et al,5 in their review of 72 cases of small-cell osteosarcoma, reported that 2 tumors
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Address correspondence and reprint requests to Kyoji Okada, MD, Department of Orthopaedics, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.