What is periosteal osteosarcoma?

Periosteal osteosarcoma, or PO, is a rare type of bone cancer. It usually forms on the surface of bones of the legs called the tibia and femur. It also can form on the surface of bones in the arms called the ulna and the humerus.

Is periosteal a cancer reaction?

Aggressive periosteal reactions can not only be seen with malignant tumors, but also with more benign processes like infection, eosinophilic granuloma (Langerhans cell histiocytosis), aneurysmal bone cyst, osteoid osteoma, hemophilia 4, and trauma.

How do you identify periosteal reactions?

A periosteal reaction is the formation of new bone in response to injury or other stimuli of the periosteum surrounding the bone. It is most often identified on X-ray films of the bones.

Can osteosarcoma be in the spine?

Osteosarcomas are found at all levels of the spine but are most common in the lumbosacral segments. Eccentric involvement of the vertebral body with extension into the posterior elements is common. Patients often present with pain and a palpable mass.

Who is at greatest risk for osteosarcoma?

Age. The risk of osteosarcoma is highest for those between the ages of 10 and 30, especially during the teenage growth spurt. This suggests there may be a link between rapid bone growth and risk of tumor formation. The risk goes down in middle age, but rises again in older adults (usually over the age of 60).

Is osteosarcoma slow-growing?

It is between high- and low-grade. Low-grade. This is slow-growing cancer. There are two sub-types of low-grade.

Is periosteal reaction Bad?

In this reaction, the periosteum has been lifted from the cortex and new bone is filling the space in a uniform manner. This reaction may be thick or thin, straight or undulating, variable in opacity, and have distinct or indistinct margins. These reactions are generally benign and usually signify benign disease.

What does periosteal mean?

The periosteum is a membranous tissue that covers the surfaces of your bones. The only areas it doesn’t cover are those surrounded by cartilage and where tendons and ligaments attach to bone.

What percentage of bone loss is required before lysis can be detected radiographically?

At least 30% cancellous bone loss is required to visualize an intramedullary destructive process, such as myeloma, with radiographs and no extramedullary disease can be shown.

Why do periosteal reactions occur?

The causes of periosteal reaction are broad, including trauma, infection, arthritis, tumors, and drug-induced and vascular entities. When periosteal reaction occurs in a bilateral distribution, a systemic disease process should be considered.

Can you survive osteosarcoma?

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed….Osteosarcoma 5-year relative survival rates.

Does osteosarcoma cause back pain?

Almost all people with spinal osteosarcoma will experience back pain at the site of the tumor, and some may have weakness, sensory loss, or loss of bowel or bladder control if the tumor is in the pelvis or base of the spine (lumbar, low back) as the tumor can lead to nerve compression at the spinal canal or along the …

What’s the difference between periosteal and high grade osteosarcoma?

it is difficult to differentiate periosteal osteosarcoma from the conventional high grade osteosarcoma at imaging, however conventional osteosarcomas involve entire circumference of cortex and show intramedullary extension.

What are the radiologic features of an osteosarcoma?

The distinctive radiologic features of conventional osteosarcoma, as demonstrated by radiography, are medullary and cortical bone destruction, an aggressive periosteal reaction, a soft-tissue mass, and tumor bone either within the destructive lesion or at its periphery, as well as within the soft-tissue mass (Fig. 21.3).

How is the periosteal reaction related to bone formation?

solid periosteal reaction along the cortex of a bone However, with rapidly growing processes, the periosteum cannot produce new bone as fast as the lesion is growing. Therefore, rather than a solid pattern of new bone formation, we see an interrupted pattern.

When do you see a periosteal reaction in a tumor?

The usual way that this may manifest is when there is a fracture or infection in the same area as a tumor. In this case, you may see a fairly complex pattern of periosteal reaction that demonstrates some elements that look benign and some that look very aggressive.