Juxtacortical (parosteal) osteogenic sarcoma: histological grading and prognosis.

In twenty-four cases of juxtacortical osteogenic sarcoma, three histological grades of malignancy were identified and correlated with the prognosis. The eighteen patients with Grade-I or II tumors had a significantly better prognosis than the six with Grade-III lesions. The three grades could not be distinguished roentgenographically. Grade I and II tumors, which showed a high cure rate after amputation, may be amenable to en block resection, provided the entire tumor can be removed with a good margin of uninvolved soft tissue and underlying bone. Grade-III tumors, on the other hand, had a poor prognosis despite early radical surgery.