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Extraskeletal osteosarcoma: a clinicopathologic study of four cases.

Four cases of extraskeletal osteosarcoma which were treated at the National Cancer Center Hospital have been reviewed. There were three males and one female. The ages of the patients were 32, 48, 48 and 59 years. Three patients had a solitary tumor located in the lower leg, thigh or postirradiated abdominal wall. The remaining patient had multiple tumors in the ipsilateral thigh and buttock. The predominant histologic subtype was osteoblastic in two cases, chondroblastic in one and malignant fibrous histiocytoma-like in one. Only one patient with a subcutaneous tumor was free of disease 16 years after a wide local excision without chemotherapy. The other three patients, two having undergone inadequate initial surgery, and one with multiple tumors, developed pulmonary metastases within 24 months of their initial surgical treatment. All of them died of the pulmonary metastases eight, 36 and 63 months after their initial treatment. Postoperative intensive chemotherapy was given to two patients. Although both had developed metastases to the lung, they received resection of the metastases combined with additional chemotherapy, surviving for more than 24 months after the occurrence of their first metastases.