Radiological study of 12 high-grade surface osteosarcomas

Objective: The purpose of our study was to report the imaging characteristics of 12 high-grade surface osteosarcomas, diagnosed, staged, treated and followed up in a single institution. Design and patients: There were 3 females and 9 males ranging in age from 15 to 34 years (mean 20 years). The radiological documents (plain films in all patients, CT scans in 8 and MR images in 6) were reviewed and compared with the histological findings. Results: Disease sites were the femur (7), tibia (4) and fibula (1). Tumor size varied from 6 to 17 cm. The cortex appeared normal in two patients, thick in seven and/or thin in five. The tumor showed dense ossification in all except in one case where ossification was slight. Minimal marrow involvement was visible in two cases on CT/MRI. Only one case exhibited a satellite nodule in a previous biopsy tract. Two cases radiologically mimicked periosteal osteosarcoma. Conclusion: High-grade surface osteosarcomas are often characterized by the presence of an ossified mass contiguous with and originating from the cortical bone with no or minimal marrow involvement.