A Case Report of Dedifferentiated Parosteal Osteosarcoma.

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We report a case of dedifferentiated parosteal osteosarcoma in the right distal femur. In this case, the dedifferentiation occurred 7 years after diagnosis without any surgical treatment during this period. The patient was treated by wide excision of the tumor and reconstruction with Kotz modular system followed by multidrug chemotherapy. The postoperative course was uneventful.Dedifferentiated lesion was clearly detected by magnetic resonance imaging in which it was shown as having iso signal intensity with T1-weighted images, high signal intensity with T2-weighted images. Additionally, intramedullary invasion was more precisely demonstrated by MRI than by CT. Radiographically, MRI was the most helpful in evaluating the extent of dedifferetiated lesion.It has been reported that in most cases dedifferentiation of parosteal osteosarcomas occurred after several recurrences. Therefore this case demonstrates the natural history of a parosteal osteosarcoma over a 7 year untreated period.
西日本整形・災害外科学会の論文