Journal
SKELETAL RADIOLOGY
Volume 50, Issue 1, Pages 9-28Publisher
SPRINGER
DOI: 10.1007/s00256-020-03546-1
Keywords
Surface lesions; Surface tumors; Surface sarcoma; Surface osteosarcoma; Parosteal osteosarcoma; Periosteal osteosarcoma; High-grade surface osteosarcoma; Intracortical osteosarcoma; Periosteal chondrosarcoma; Juxtacortical chondrosarcoma; Periosteal Ewing sarcoma
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Surface lesions of bone are rare, presenting a diagnostic challenge due to their distinct characteristics and unusual location compared to intramedullary lesions. Surface sarcomas are typically lower grade, with osteosarcoma showing different entities in juxtacortical or surface form. Accurate imaging diagnosis is crucial for understanding the biological features of surface bone lesions.
Surface lesions of bone are uncommon. Although their imaging features generally mirror those of their intramedullary counterparts, surface lesions may demonstrate distinct characteristics which along with their unusual location present a diagnostic challenge. Surface sarcomas are usually of a lower grade compared with intramedullary variants, leading to differences in management. Osteosarcoma arising from the cortical surface of the bone is termed juxtacortical or surface osteosarcoma and includes three distinct entities: parosteal, periosteal, and high-grade surface osteosarcoma. We also review the features intracortical osteosarcoma, which some authors include under the umbrella term surface osteosarcoma. These lesions exhibit biologic features distinct from those of conventional intramedullary osteosarcoma, which underlines the importance of accurate imaging diagnosis. Periosteal chondrosarcoma and periosteal Ewing sarcoma also have distinctive imaging appearances. The purpose of this article is to review surface sarcomas of bone with regard to their clinical and radiological features and to discuss the differential diagnosis for each condition.
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