LOW-GRADE CENTRAL OSTEOGENIC-SARCOMA - A LONG-TERM FOLLOW-UP OF 20 PATIENTS

Osteogenic sarcoma is a heterogeneous family of tumors that has a vari able biologic behavior. Low grade central osteogenic sarcoma is an unc ommon form that is characterized by a long premorbid history and is co mpatible with prolonged survival after treatment. Twenty cases of low grade central osteosarcoma with long-term followup (16 [2.5-48] years) were studied retrospectively. The age distribution was broad (range, 15-83 years). All tumors arose in the lower limb. The primary symptom was pain; mean duration was 44 months (range, 1-180 months). A diagnos is of low grade central osteosarcoma was made primarily for 11 patient s. For 9 others, fibrous dysplasia (3), nonossifying fibroma (2), fibr oma (1), chondromyxoid fibroma (1), chondrosarcoma (1), and simple bon e cyst (1) were diagnosed initially. Intralesional surgery was associa ted with recurrence in every case. Radical margins were not associated with local recurrence. Four recurrences were higher grade and 1 was d edifferentiated. Three of 4 patients with metastases died of their dis ease. Five- and 10-year survival was 90% and 85%, respectively. Histol ogy and radiology are complementary for confirming the diagnosis. Low grade central osteosarcoma seems to be controllable by surgery alone i f at least wide margins are used.