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Skeletal Radiol (2012) 41:10111015 DOI 10.1007/s00256-012-1375-8
CASE REPORT
Case report: periosteal osteosarcoma of the clavicle
C. Lim & H. Lee & J. Schatz & F. Alvaro & R. Boyle &
S. F. Bonar
Received: 8 November 2011 /Revised: 25 January 2012 /Accepted: 29 January 2012 /Published online: 19 February 2012 # ISS 2012
Abstract Periosteal osteosarcomas are rare and usually affect the meta-diaphyseal region of long bones. We present a case of a periosteal osteosarcoma of the clavicle, a highly unusual site and representing one of only two such cases documented in the English literature. This case illustrates the diagnostic dilemmas in the classification of such tumors, particularly in small biopsy specimens from unusual locations. It emphasizes the importance of radiological and pathological correlation.
Keywords Osteosarcoma . Periosteal . Juxtacortical .
Clavicle
C. Lim : S. F. BonarDouglass Hanly Moir Pathology, Macquarie Park,New South Wales, Australia
C. Lime-mail: [email protected]
H. Lee (*) : R. BoyleDepartment of Orthopaedic Surgery, Royal Prince Alfred Hospital, Missenden Road,Camperdown, New South Wales, Australiae-mail: [email protected]
J. SchatzDepartment of Radiology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
F. AlvaroThe Childrens Cancer and Haematology Services, John Hunter Childrens Hospital,Newcastle, New South Wales, Australia
R. BoyleBone and Soft Tissue Sarcoma Service, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
Introduction
Periosteal osteosarcoma is a variant of chondroblastic osteosarcoma, classified under the juxtacortical group of osteosarcomas [1]. It most commonly occurs on the surface of long bones, particularly the femur and tibia. The overall prognosis is better than that of conventional osteosarcoma. We report the second case in the English language literature of periosteal osteosarcoma of the clavicle.
Case report
A 16-year-old Caucasian female presented with a painful mass anteriorly over her right clavicle, which had been increasing in size over the previous 6 monthsinitially noted after a fall from a horse. She had a history of acute myeloid leukemia (AML) at age 10 months, treated successfully with standard intensive chemotherapy and an autologous bone marrow transplant. There was no family history of malignancy.
Clinical examination revealed a 3~4 cm firm mass over the right clavicle. X-ray showed a poorly defined, surface-based lesion arising from the mid shaft of the right clavicle. There was cortical thickening that appeared quite solid inferiorly, but...