Anal extraskeletal osteosarcoma in a man: a case report and review of the literature

Extra-skeletal osteosarcoma: a review

Extra-skeletal osteosarcoma is a rare malignant soft tissue sarcoma which can cause a diagnostic challenge due to its non-specific presentation and soft tissue mineralisation, thus potentially mimicking conditions such as myositis ossificans. This review will outline the demographics, clinical presentation, key imaging features, differential diagnosis, management and outcomes of extra-skeletal osteosarcoma and serve as a reference to radiologists and other clinicians involved in the care of patients with soft tissue tumours and tumour-like lesions.

A high-grade primary osteosarcoma arising in the splenic flexure of the colon: an extremely rare entity

Extraskeletal osteosarcoma (ESOS) is an uncommon malignant mesenchymal tumour deriving from soft tissues or visceral organs without any evidence of a primary bone osteosarcoma. Although ESOS has been mainly reported in the extremities, it can also occur in unusual locations such as the colorectal region. A 58-year-old man with a 3-month history of dyspepsia, constipation and soreness in the left upper abdominal quadrant was admitted to hospital. Computed tomography and magnetic resonance imaging demonstrated a huge, irregular, mixed cystic and solid, partially calcified mass measuring 116mm×140mm×200mm. Because of the patient's obstructive symptoms, surgery was performed. A tumour involving the splenic flexure of the colon was excised in line with oncological principles by extended left hemicolectomy with end-to-side colo-colonic anastomosis. The specimen was interpreted as a primary osteosarcoma of the colon after immunohistochemical straining. Considering the limited data regarding ESOS arising in colon, we present the second case to date that involves the transverse colon, to further elucidate its clinical aspects, prognosis and treatment options.

Primary Osteosarcoma of the Urinary Bladder Metastatic to Lung

Extra-skeletal osteosarcoma (ESOS) is a rare neoplasm that represents less than 2% of all soft tissue sarcomas. Common reported sites of involvement include limbs, retroperitoneum, chest wall and buttocks. ESOS arising primarily in parenchymatous organs are extremely uncommon, with the involvement of the urinary bladder is even rarer. We herein report a case of primary ESOS of the urinary bladder in a 48 year-old male patient.

FVIII at the crossroad of coagulation, bone and immune biology: Emerging evidence of biological activities beyond hemostasis

Hemophilia A is an X-linked hereditary disorder that results from deficient coagulation factor VIII (FVIII) activity, leading to spontaneous bleeding episodes, particularly in joints and muscles. FVIII deficiency has been associated with altered bone remodeling, dysregulated macrophage polarization, and inflammatory processes that are associated with the neoformation of abnormal blood vessels. Treatment based on FVIII replacement can lead to the development of inhibitors that render FVIII concentrate infusion ineffective. In this context, hemophilia has entered a new therapeutic era with the development of new drugs, such as emicizumab, that seek to restore the hemostatic balance by bypassing pathologically acquired antibodies. We discuss the potential extrahemostatic functions of FVIII that may be crucial for defining future therapies in hemophilia.

Subcutaneous extraskeletal osteosarcoma of foot: A case report

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Subcutaneous extraskeletal osteosarcoma is a rare high grade mesenchymal sarcoma.

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The exact diagnosis can be established with histologic study.

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Wide marginal resection is associated with a decreased risk of local recurrence and metastasis.

Introduction

Subcutaneous extraskeletal osteosarcoma (ESO) is a rare high grade malignant mesenchymal neoplasm consistent of approximately 1% of soft tissue sarcoma. Less than 10% of ESOs are superficial, originating in subcutis.

Presentation of case

We reported a 72 years old male with chief complain of a painless slowly growing soft tissue mass in his plantar aspect of right foot in the last 9 months before admission. The plain radiography showed a large subcutaneous soft tissue mass in plantar area and heel, Magnetic resonance images displayed an irregular subcutaneous soft tissue mass extending from posterior lower leg to ankle and involving calcaneus inferiorly. A percutaneous core biopsy of the mass, obtained. The histopathology examination confirmed an soft tissue osteosarcoma. Subsequent wide local excision of the mass performed. Final histopathological result was subcutaneous extraskeletal osteosarcoma.

Discussion

The patient has had no evidence of recurrence or/and distant metastasis at 25 months followed up. However, excising subcutaneous ESOs with a safe surgical margin is paramount for achieving the best outcome.

Conclusion

A subcutaneous ESO is a rare malignant tumor. We recommended that along with clinicohistological findings, radiological correlation is necessary for ruling out other diagnoses.