Intracortical osteosarcoma

Last revised by Andrew Murphy on 21 Jul 2017

Citation, DOI, disclosures and article data

Citation:

Mudgal P, Glick Y, Kang O, et al. Intracortical osteosarcoma. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-27391

DOI:

https://doi.org/10.53347/rID-27391

Permalink:

https://radiopaedia.org/articles/27391

rID:

27391

Article created:

1 Feb 2014, Prashant Mudgal

Disclosures:

At the time the article was created Prashant Mudgal had no recorded disclosures.

View Prashant Mudgal's current disclosures

Last revised:

21 Jul 2017, Andrew Murphy ◉

Disclosures:

At the time the article was last revised Andrew Murphy had no recorded disclosures.

View Andrew Murphy's current disclosures

Revisions:

5 times, by 5 contributors - see full revision history and disclosures

Systems:

Musculoskeletal

Tags:

Synonyms:

Intracortical osteosarcomas

Intracortical osteosarcoma is the rarest variety of osteosarcoma and represents less than 1% of all osteosarcoma cases.

Intracortical osteosarcoma is a low-grade tumor of cortical bones and typically does not extend into the medullary canal and surrounding soft tissue until the late stages of the disease. Histologically, it is characterized as a sclerosing variant of the osteosarcoma and contains osteoid matrix with few fibroblastic foci and a mild degree of cellular atypia.

Location

The tibial diaphysis is the most common site of this tumor.

Radiographic features

Plain radiograph

It typically presents as an oval intracortical geographic osteolytic lesion in the diaphysis with surrounding sclerosis and usually measures about 4 cm in length. Multiple calcific foci can be seen within the lytic region, suggesting osteoid matrix.

CT

CT reveals an osteolytic lesion with surrounding sclerosis and, rarely, calcific specks in its matrix.

MRI

It was believed that an intracortical osteosarcoma is confined to the cortex of the bone and does not show intramedullary or superficial involvement but, in fact, it may invade the medullary canal as well as the surrounding soft tissue.

T1: hypointense
T2: intermediate to high signal intensity
STIR: to facilitate detection of perilesional edema and intramedullary tumor extension
T1 C+: peripheral enhancement

Treatment and prognosis

Although reported cases have shown slow progression and a low-grade histological appearance, recurrence and distant metastases have been reported. The ideal treatment is surgical resection with an adequate margin; adjuvant chemotherapy can be considered. Following surgical resection and adjuvant chemotherapy, the overall prognosis is good.