Secondary osteosarcomas diagnosed in a single institution: 7 cases in 10 years

Abstract

Aims: Osteosarcoma is the most common, non-hematopoietic primary malignant tumor of bone. Osteosarcomas develop de novo in apparently normal bone. However, some benign bone tumors and non-neoplastic conditions may undergo malignant transformation into osteosarcomas. Such osteosarcomas are called secondary osteosarcoma. The scope of this article is to report on a ten-year experience of secondary osteosarcoma in a single institution.Materials and methods: The archives of Uludag University Medical School Department of Pathology were screened for cases of secondary osteosarcoma between January 2002 and June 2013. Demographics, clinical and pathological data are listed.Results: Of the 62 cases of osteosarcoma diagnosed in the period, 7 were secondary osteosarcomas. There were 5 male and 2 female patients. In 4 cases, the secondary osteosarcomas were due to radiation therapy. The index lesion was Paget's disease of bone, bone infarct and giant cell tumor of bone in the other cases. Index lesions included breast carcinoma, Ewing's sarcoma, rhabdomyosarcoma, and primitive neuroectodermal tumor for postradiation osteosarcomas. Unfortunately all patients passed away except for 3 cases of postradiation osteosarcoma.Conclusion: In cases of benign situations having a tendency of malignant transformation including giant cell tumor of bone, bone infarct, Paget's disease, and areas of former radiation therapy, clinical and radiological findings may be of great help in detecting in earlier stages of malignant transformation, and more promising for a disease free survival.