Dr. Francisco Bengoa
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Bone tumors

High-grade surface osteosarcoma

BoneMalignant / sarcomaOsteogenic tumours

Epidemiology

A rare variant of osteosarcoma that arises on the surface of the bone and behaves like a high-grade tumor. Although it arises on the surface, its high grade requires staging and planning similar to other aggressive osteosarcomas.

Basic features

It can be confused with other surface tumors, so the correlation between imaging, biopsy, and the exact site is critical.

Usual treatment

It is treated with systemic chemotherapy and wide resection, similar to high-grade central osteosarcoma. Before chemotherapy starts it is worth discussing fertility preservation with the team, because some of these treatments can affect it and the options have to be raised beforehand.

Outcomes and prognosis

It behaves like a high-grade osteosarcoma: the prognosis depends on systemic control and on the margins, and it must not be managed as a low-grade surface lesion.

Warning signs

These signs do not necessarily mean cancer, but they warrant evaluation before operating on or needling a mass.

  • A soft-tissue mass that grows, is larger than 5 cm, or is deep.
  • Persistent, night-time or progressive bone pain, especially if it limits activity.
  • A fracture from minimal trauma, or an aggressive bone lesion on an X-ray.
  • A lump that comes back after previous surgery.
  • Neurological symptoms, rapid swelling, or pain associated with a mass.

This information is general and does not replace a medical evaluation. A musculoskeletal tumor must be interpreted together with imaging, physical examination, biopsy when appropriate and each patient's context.

Specialist evaluation

If you have a mass, a bone lesion or a report suggesting a tumor, book an evaluation.

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