J Pathol Transl Med.  2021 Nov;55(6):406-409. 10.4132/jptm.2021.06.22.

Rosette-forming epithelioid osteosarcoma in the rib: a rare case of location and morphology

• Oh SJ

• KMID: 2522442
• DOI: http://doi.org/10.4132/jptm.2021.06.22

Abstract

The rib is an unusual location for osteosarcoma and is reported in only 2% of all cases. The major histological variants of osteosarcoma are osteoblastic, chondroblastic, and fibroblastic, with a few rare variants including one epithelioid type. This report describes a 44-year-old male with an osteolytic mass in the right seventh rib. Histological examination revealed osteosarcoma with unique features of epithelioid appearance and rosette structures. To the best of our knowledge, this is the first reported case of a rosette-forming osteosarcoma of the rib that showed epithelioid morphology. Despite successful surgery, the patient’s prognosis was poor because this malignancy had an unusual location within the axial skeleton and was a rare histological variant.

Keyword

Osteosarcoma; Ribs; Epithelioid; Rosette

Figure

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  Fig. 1 Radiologic images. (A) Chest radiograph showing an oval mass (arrow) in the right thorax. (B) Computed tomography scan of the chest, revealing a large, heterogeneously enhanced mass (arrow) that originated from the right seventh rib, with lytic destruction of the bone and coarse calcification.

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  Fig. 2 Epithelioid osteosarcoma of the rib. (A) Macroscopic picture of an ill-defined lytic mass of the rib with hemorrhagic cystic degeneration. (B) Microscopic view of the trabecular and rosette-forming pattern that contained a fibrillar matrix in the center. (C) Rosette-like structures of plasmacyoid tumor cells with eccentrically located nuclei and abundant pale cytoplasm. (D) Mixed epithelioid and plasmacytoid tumor cells. (E) Blood-filled cystic spaces showing telangiectatic features. (F) Neoplastic bones produced by malignant tumor cells are found throughout the lesion.

Reference

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