Korean J Radiol.  2014 Jun;15(3):370-375. 10.3348/kjr.2014.15.3.370.

Periosteal Osteosarcoma Arising from the Rib and Scapula: Imaging Features in Two Cases

• Hong JB
• Cho KH
• Choi JH

• KMID: 2078647
• DOI: http://doi.org/10.3348/kjr.2014.15.3.370

Abstract

Periosteal osteosarcoma is an extremely rare chondroblastic osteosarcoma in the flat bone. There were authors reporting of two cases of periosteal osteosarcoma in the highly unusual sites. One of them arose from the rib, in a 17-year-old male, which appeared as a hypodense juxtacortical mass with periosteal reaction on CT. The other one arose from the scapula, in a 17-year-old female, which showed the intermediate signal intensity (SI) on T1-weighted image (WI), heterogeneous high SI on T2WI, and rim-enhancement on contrast-enhanced T1WI with cortical destruction on MRI.

Keyword

Bone surface tumor; Osteosarcoma; Rib; Scapula; Chest wall

MeSH Terms

Adolescent
Bone Neoplasms/*radiography
Contrast Media/diagnostic use
Female
Humans
Male
Osteosarcoma/*radiography
Ribs/*radiography
Scapula/*radiography
Contrast Media

Figure

• 

  Fig. 1 17-year-old male with periosteal osteosarcoma in right 7th rib. A. Simple chest radiograph shows poorly defined triangular calcific opacity (Codman's triangle, black arrow), with periosteal reactions (white arrows) on outer surface of lateral arc of right 7th rib, without evidence of rib destruction. B. Non-enhanced CT scan with bone setting shows thin-walled, juxtacortical, hypodense mass (arrows) and periosteal reaction with fine, perpendicular spicules extending from thickened, adjacent cortex of rib (arrowheads). C. CT with contrast enhancement demonstrated fine septal and wall enhancement of hypodense mass (black arrowheads) and periosteal reaction with cortical thickening (white arrows). D. Gross specimen in cut-section shows surface tumor of rib with medullary infiltration. E. Microscopic examination shows definite areas of calcified tumor osteoid (arrows) within chondroid matrix (hematoxylin and eosin stain, × 100).

• 

  Fig. 2 17-year-old girl with periosteal osteosarcoma in right scapula. A, B. MR imaging shows intermediate signal intensity in mass on T1-weighted image (A, arrows) and heterogeneous high signal intensity on T2-weighted image (B, arrows). C. Axial scan of fat-saturated and contrast-enhanced T1-weighted image shows rim enhancement of mass (arrows). D. On sagittal scan of contrast-enhanced T1-weighted image, mass is mainly seen located in supraspinatus muscle in suprascapular fossa (white arrows), with cortical destruction of underlying scapular spine (black arrowhead), and partially extending posteriorly to subcutaneous fat layer (black arrows). E. Post-MR fluoroscopy on craniocaudal projection, with patient in supine position, well-depicts soft tissue opacity (white arrows) with inner calcified matrix (black arrowhead) in suprascapular fossa. F. Microscopically, cortical bony erosion (arrowheads) and focal intramedullary involvement (arrows) are present (hematoxylin and eosin stain, × 10).

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