POST-PAGET OSTEOSARCOMAS OF THE SKULL - REMARKS ON 5 CASES

We report our experience with 5 cases of post-Paget osteosarcoma of th e skull, a rare lesion of the neurocranium. Four patients were treated by surgery and radiotherapy and by surgery alone. Two patients receiv ed chemotherapy. Histologically, the tumor was found to be a osteosarc oma, fibroblastic in 2 cases, mixed in 2, and osteoblastic in 1. Combi ned treatment (surgery, radiotherapy and chemotherapy) positively infl uenced survival (median survival, 6 months). The prognosis for post-Pa get osteosarcomas of the skull seems to be worse than for primary sarc omas, probably due to their intense vascularization. This facilitates the spread of tumor cells to other organs (as observed in our cases) a nd reduces the reduced effectiveness of chemotherapy. Although the lat ter lengthens survival and reduces the incidence of metastases, it is not as efficacious as in primary sarcomas.