Myositis ossificans mimicking bone surface osteosarcoma: case report with literature review

Myositis ossificans, a benign tumor composed of spindle cells and osteoblasts, can clinically and radiologically mimic osteosarcoma. While recognition and accurate diagnosis of myositis ossificans can be a challenge, this is critical as it may allow a conservative surgical approach to maximize funct...

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Published in:APMIS : acta pathologica, microbiologica et immunologica Scandinavica microbiologica et immunologica Scandinavica, 2024-08, Vol.132 (8), p.535-543
Main Authors: Werenski, Joseph O, Hung, Yin P, Chang, Connie Y, Nielsen, G Petur, Lozano‐Calderón, Santiago A
Format: Article
Language:English
Subjects:
Biopsy
Bone cancer
Bone imaging
Bone matrix
Bone tumors
Collagen (type I)
Computed tomography
Fluorescence in situ hybridization
Gene fusion
Immunohistochemistry
Literature reviews
Magnetic resonance imaging
Medical imaging
Myositis
Myositis ossificans
Osteosarcoma
surface osteosarcoma
translocation assay
Tumors
USP6
Zonal distribution
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Summary:Myositis ossificans, a benign tumor composed of spindle cells and osteoblasts, can clinically and radiologically mimic osteosarcoma. While recognition and accurate diagnosis of myositis ossificans can be a challenge, this is critical as it may allow a conservative surgical approach to maximize functional outcomes. Herein, we present a patient with surface myositis ossificans confirmed genetically by the presence of COL1A1::USP6 gene fusion, along with a literature review. Due to the enhanced visualization of the bone matrix, computed tomography (CT) imaging may be a superior imaging modality to magnetic resonance (MR) imaging. Staged biopsies with samples obtained from the periphery and center of the lesions may allow pathologists to discern the zonal distribution histologically. Furthermore, immunohistochemistry fluorescence in situ hybridization and molecular testing can aid in the distinction of myositis ossificans from mimics. Because of their resemblance to other bone tumors, these cases of myositis ossificans highlight the importance of a multidisciplinary approach integrating clinical, radiologic, and pathologic analysis and involving serial imaging, sampling, and judicious use of ancillary immunohistochemical and molecular testing.
ISSN:0903-4641
1600-0463
1600-0463
DOI:10.1111/apm.13422