Atypical "Sclerosing" Osteoblastic Neoplasm: A Tumor of Intermediate Biological Potential Between Usual Osteoblastoma and Conventional Osteosarcoma

The American Journal of Surgical Pathology
Kelsey E McHughScott E Kilpatrick

Abstract

The existence of "aggressive" osteoblastoma (OB) or malignant transformation of OB is controversial. Over a few decades, we have encountered a group of "borderline" sclerosing osteoblastic lesions that are difficult to classify, tending toward local recurrence, especially following curettage. A search of the consultative and institutional files from 3 co-authors for atypical OB, malignant transformation of OB, well-differentiated osteosarcoma (OS), and OB-like OS diagnoses revealed 8 similar cases. There were 6 males and 2 females, ages 11 to 55 years (mean, 26 y). Three arose in metatarsals, 2 in the fibula, and 1 each in the humerus, tibia, and femur. Radiologically, most were expansile, lytic to sclerotic, with circumscribed and at least partially sclerotic borders. Pathologically, all displayed a predominant, sclerosing sheet-like neoplastic bone growth pattern, associated with minor components of conventional OB. No solid sheets of osteoblasts or permeation of surrounding bone were identified. Six cases were reviewed by >1 expert orthopedic pathologist, often with divergent opinions. Four were initially diagnosed as OB, 2 as low-grade OS, 1 as high-grade OS, and 1 as atypical sclerosing osteoblastic neoplasm. Clinical foll...Continue Reading

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Citations

Sep 21, 2020·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Ashutosh RathAnil Dhal
Apr 6, 2021·Seminars in Ultrasound, CT, and MR·Behrang AminiTamara Miner Haygood

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Methods Mentioned

BETA
amputation
biopsy
surgical resection

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