parosteal osteosarcoma
pa·ros·te·al os·te·o·sar·co·ma
parosteal osteosarcoma
An uncommon (4% of all osteosarcomas (OS)) indolent, painless OS of patients age 30 to 60, which arises in the metaphysis and is confined to the surface long bones (posterior distal femur, tibia, humerus; rarely hands or mandible). Parosteal OS lacks intramedullary involvement; it has mature lamellar bone, fibrous stroma, minimally increased cellularity, atypia and increased mitotic activity. Up to 70% arise on the surface of the distal femur. Recurrent parosteal OSs may dedifferentiate.Imaging
Prominent extracortical calcified mass encircling bone.
Prognosis
Generally good—80% 5-year survival; recurrence with dedifferentiation significantly worsens the prognosis.