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Wang XC, Zhang L, Lin JB, Huang XY, Liang JH, Zhong JP, Peng JD, Zhong JY. Imaging diagnosis and differential diagnosis of extraskeletal osteosarcoma. BMC Cancer 2024; 24:11. [PMID: 38166700 PMCID: PMC10763387 DOI: 10.1186/s12885-023-11731-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE The aim of this study was to investigate the clinical, imaging and pathological features of extraskeletal osteosarcoma (EOS) and to improve the understanding of this disease and other similar lesions. METHODS The data for 11 patients with pathologically confirmed extraosseous osteosarcoma, including tumour site and size and imaging and clinical manifestations, were analysed retrospectively. RESULTS Six patients were male (60%), and 5 were female (40%); patient age ranged from 23 to 76 years (average age 47.1 years). Among the 11 patients, 7 had clear calcifications or ossification with different morphologies, and 2 patients showed a massive mature bone tumour. MRI showed a mixed-signal mass with slightly longer T1 and T2 signals in the tumour parenchyma. Enhanced CT and MRI scans showed enhancement in the parenchyma. Ten patients had different degrees of necrosis and cystic degeneration in the mass, 2 of whom were complicated with haemorrhage, and MRI showed "fluid‒fluid level" signs. Of the 11 patients, five patients survived after surgery, and no obvious recurrence or metastasis was found on imaging examination. One patient died of lung metastasis after surgery, and 2 patients with open biopsy died of disease progression. One patient died of respiratory failure 2 months after operation. 2 patients had positive surgical margins, and 1 had lung metastasis 6 months after operation and died 19 months after operation. Another patient had recurrence 2 months after surgery. CONCLUSION The diagnosis of EOS requires a combination of clinical, imaging and histological examinations. Cystic degeneration and necrosis; mineralization is common, especially thick and lumpy mineralization. Extended resection is still the first choice for localized lesions. For patients with positive surgical margins or metastases, adjuvant chemoradiotherapy is needed.
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Affiliation(s)
- Xiao-Chun Wang
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China
| | - Ling Zhang
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Jiong-Bin Lin
- Department of Radiology, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China
| | - Xiao-Yao Huang
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China
| | - Jing-Hong Liang
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China
| | - Jian-Ping Zhong
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China
| | - Ji-Dong Peng
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China.
| | - Jun-Yuan Zhong
- Ganzhou Institute of Medical Imaging, Ganzhou Key Laboratory of Medical Imaging and Artificial Intelligence, Medical Imaging Center, Ganzhou People's Hospital, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou Hospital-Nanfang Hospital, Southern Medical University, Ganzhou, 341000, China.
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Yang J, Chen X, Li X, Liu W, Liao S, Wang Y, Zuo Y. Case Report: Clinical application of immunotherapy-based combination regimen in primary osteosarcoma of the uterus. Front Oncol 2023; 13:1198765. [PMID: 37469418 PMCID: PMC10352772 DOI: 10.3389/fonc.2023.1198765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/01/2023] [Indexed: 07/21/2023] Open
Abstract
Primary osteosarcoma of the uterus is an extremely rare pure heterologous sarcoma of the uterus. The relevant available information is limited to case reports. To date, only 31 cases of this type of cancer have been reported. Here, we report the first clinical experience with the administration of an immunotherapy-based combination regimen for multiple metastatic primary osteosarcomas of the uterus. The patient had undergone multiple treatments prior to this regimen, but her condition continued to progress. However, after 3 cycles of immunotherapy combined with targeted therapy and chemotherapy, a review showed that the disease was stable and even in partial remission. The patient has a good quality of life, and long-term survival is expected.
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Affiliation(s)
- Jing Yang
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaowen Chen
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaofang Li
- Department of Pathology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Wenci Liu
- Department of Imaging, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Sihai Liao
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yuzhou Wang
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yufang Zuo
- Department of Gynecological Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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