Osteoblastoma‐like osteosarcoma: high‐grade or low‐grade osteosarcoma?

Aims Osteoblastoma‐like osteosarcoma is a rare variant of osteosarcoma (1% of all osteosarcomas), histologically similar to osteoblastoma. In the current World Health Organisation (WHO) classification, osteoblastoma‐like osteosarcoma is classified within the group of conventional (high‐grade) osteos...

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Bibliographic Details
Published in:Histopathology 2019-02, Vol.74 (3), p.494-503
Main Authors: Gambarotti, Marco, Dei Tos, Angelo P, Vanel, Daniel, Picci, Piero, Gibertoni, Dino, Klein, Michael J, Righi, Alberto
Format: Article
Language:English
Subjects:
Adolescent
Adult
Bone cancer
Bone Neoplasms - mortality
Bone Neoplasms - pathology
Child
Disease-Free Survival
Female
grading
Humans
Kaplan-Meier Estimate
Male
Metastases
Middle Aged
Morphology
Neoplasm Grading
Osteoblastoma
Osteoblastoma - mortality
Osteoblastoma - pathology
Osteosarcoma
Osteosarcoma - mortality
Osteosarcoma - pathology
prognosis
Statistical analysis
Surgery
Tumors
Young Adult
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Summary:Aims Osteoblastoma‐like osteosarcoma is a rare variant of osteosarcoma (1% of all osteosarcomas), histologically similar to osteoblastoma. In the current World Health Organisation (WHO) classification, osteoblastoma‐like osteosarcoma is classified within the group of conventional (high‐grade) osteosarcomas. However, several published cases have been actually regarded as low‐grade malignant tumours. As strict morphological criteria to distinguish between low‐ and high‐grade lesions are not available, we reviewed our series of osteoblastoma‐like osteosarcomas in the attempt to identify clinical and morphological features predictive of aggressiveness. Methods and results We retrieved 15 cases of osteoblastoma‐like osteosarcoma from the files of the Istituto Ortopedico Rizzoli. Patients received various treatments. Five patients developed metastasis and five patients developed local recurrences (all after incomplete surgery). Eleven patients were alive without disease, while four patients died of their disease. Statistical analysis revealed a statistically significant (P = 0.048) lower disease‐free survival in patients with areas of conventional (high‐grade) osteosarcoma. Conclusions With the important limitation of a small cohort of patients, the presence of areas of conventional (high‐grade) osteosarcoma is the only parameter to predict the aggressiveness of osteoblastoma‐like osteosarcoma.
ISSN:0309-0167
1365-2559
DOI:10.1111/his.13746