Osteosarcoma classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview

Osteosarcoma (OS) is a rare bone cancer which affects both adolescents and young adults. Osteosarcoma was classified as primary and secondary. Later the the World Health Organization sub-typed as intramedullary/central and surface osteosarcoma with a number of sub-types under each group.

Osteosarcoma (OS) may be classified into several subtypes based on World Health Organization and are as follows:^[1]^[2]^[3]^[4]^[4]^[5]^[1]^[6]^[7]

Classification of osteosarcoma
Primary osteosarcoma	Conventional–intramedullary/central high grade (most common) further sub-typed as:	Osteoblastic (50%) Chondroblastic (25%) Fibroblastic (25%)
Secondary osteosarcoma	Unusual forms of osteosarcoma given below are viewed as subtypes of conventional osteosarcoma because their biological behavior is similar.	Osteoblastic osteosarcoma-sclerosing type Osteosarcoma resembling osteosarcoma Chondromyxoid fibroma‑like osteosarcoma Chondroblastoma-like osteosarcoma Clear-cell osteosarcoma Malignant fibrous histiocytoma‑like osteosarcoma Giant cell rich osteosarcoma–Epithelioid osteosarcoma

Osteosarcoma (Primary) subtypes within central and surface tumours
subtypes	Osteosarcoma
CENTRAL (MEDULLARY)	A. Conventional high-grade central osteosarcoma (80%) B. Telangiectatic osteosarcoma (4%) C. Intraosseous well-differentiated (low-grade) osteosarcoma (1-2%) D. Small cell osteosarcoma (1-2%)
SURFACE (PERIPHERAL)	a. Parosteal (juxtacortical) well-differentiated (low-grade) osteosarcoma(4-6%) b. Periosteal osteosarcoma– low- to intermediate-grade osteosarcoma(<4%) c. High-grade surface osteosarcoma(1%)

↑ ^1.0 ^1.1 Duong LM, Richardson LC (2013). “Descriptive epidemiology of malignant primary osteosarcoma using population-based registries, United States, 1999-2008”. J Registry Manag. 40 (2): 59–64. PMC 4476493. PMID 24002129.
↑ Bielack SS, Hecker-Nolting S, Blattmann C, Kager L (2016). “Advances in the management of osteosarcoma”. F1000Res. 5: 2767. doi:10.12688/f1000research.9465.1. PMC 5130082. PMID 27990273.
↑ Kundu ZS (May 2014). “Classification, imaging, biopsy and staging of osteosarcoma”. Indian J Orthop. 48 (3): 238–46. doi:10.4103/0019-5413.132491. PMC 4052020. PMID 24932027.
↑ ^4.0 ^4.1 Misaghi A, Goldin A, Awad M, Kulidjian AA (2018). “Osteosarcoma: a comprehensive review”. SICOT J. 4: 12. doi:10.1051/sicotj/2017028. PMC 5890448. PMID 29629690.
↑ Ozaki T, Flege S, Liljenqvist U, Hillmann A, Delling G, Salzer-Kuntschik M, Jürgens H, Kotz R, Winkelmann W, Bielack SS (February 2002). “Osteosarcoma of the spine: experience of the Cooperative Osteosarcoma Study Group”. Cancer. 94 (4): 1069–77. PMID 11920477.
↑ Hamre MR, Severson RK, Chuba P, Lucas DR, Thomas RL, Mott MP (December 2002). “Osteosarcoma as a second malignant neoplasm”. Radiother Oncol. 65 (3): 153–7. PMID 12464443.
↑ Barker JP, Monument MJ, Jones KB, Putnam AR, Randall RL (May 2015). “Secondary osteosarcoma: is there a predilection for the chondroblastic subtype?”. Orthopedics. 38 (5): e359–66. doi:10.3928/01477447-20150504-51. PMID 25970361.