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Intraosseous Well-differentiated Osteosarcoma

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Summary

Low Grade Osteosarcoma accounts for 1-2% of osteosarcomas. This intraosseus tumor occurs in the metaphysis and diaphysis of the distal femur or proximal tibia.

It often occurs in the older patient population.
Low Grade Osteosarcoma generally presents itself as a pathologic fracture.
On plain x-ray, low grade osteosarcoma may appear as osteolytic, ground glass, or sclerotic.
Complete Information on this Tumor
Introduction and Definition: 

Low Grade Osteosarcoma accounts for 1-2% of osteosarcomas. This intraosseus tumor occurs in the metaphysis and diaphysis of the distal femur or proximal tibia.

Incidence and Demographics: 
This type of tumor is generally uncommon and is generally found in the older patient population.
Symptoms and Presentation: 

Low-grade Osteosarcoma's often present themselves as pathologic fractures.

X-Ray Appearance and Advanced Imaging Findings: 
On plain x-ray, low grade osteosarcoma may appear as osteolytic, ground glass, or sclerotic. The bone destruction is regular and expansive which often contributes to a misdiagnosis as benign. This slow growing tumor has poorly defined margins.
Histopathology findings: 
Low grade osteosarcoma is normally a grade 1 tumor histologically. There is a large amount of collagen surrounding the occasional spindle cells. Some authors believe this tumor is a relative of parosteal osteosarcoma as they both have a similar microscopic appearance and low malignant potential.
Treatment Options for this Tumor: 
Like parosteal osteosarcoma, low grade osteosarcoma has a good prognosis. Treatment is surgical excision and is not followed by chemotherapy.
Outcomes of Treatment and Prognosis: 
Suggested Reading and Reference: 
Bloem, JL and HM Kroon, Osseous Lesions, Radiologic Clinics of North America, 31(2):261-277, March, 1993. Bullough, Peter, Orthopaedic Pathology (third edition), Times Mirror International Publishers Limited, London, 1997. Huvos, Andrew, Bone Tumors: Diagnosis. Treatment and Prognosis, W.B. Saunders, Co., 1991.