[8] and Campanacci and Giunti [4] where the authors made the case for this being recognized as a distinct entity on the grounds of the unique radiographic and histologic features with a clinical behavior distinct from other surface-based osteosarcomas such as parosteal osteosarcoma [9] and high-grade surface osteosarcoma [10].
It is noteworthy that conventional osteosarcoma (~10%), parosteal osteosarcoma (>85%), and undifferentiated high-grade pleomorphic sarcoma of bone (~17%) may be positive for mouse double minute 2 homolog (MDM2) by fluorescence in situ hybridization
The common differential diagnosis of melorheostosis includes myositis ossificans, synovial osteochondromatosis, osteoma, parosteal osteosarcoma, focal scleroderma, and Caffey disease.
Extraskeletal LGO displays histologic features resembling those of a parosteal osteosarcoma but without adipose component nor connection with the underlying bone [9].
For example, a select group of lesions is eccentrically located and involves the cortex (osteoid osteoma, parosteal osteosarcoma, and nonossify ing fibroma) (Figure 2).
Other new information relates to chondroblastoma, osteoblastoma, and parosteal osteosarcoma, and the section on neoplasm simulators has been expanded to include conditions like neuropathic joint that may present as a neoplasm.
The differential diagnosis of PL includes osteochondroma, myositis ossificans, parosteal osteosarcoma, soft tissue lipoma, liposarcoma, and chondrosarcoma.
* Parosteal osteosarcoma. A low-grade, slow-growing and bone-forming tumor found on the surface of long bones, parosteal osteosarcoma accounts for 3% of osteosarcoma diagnoses.
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