Periosteal osteosarcoma.

Periosteal osteosarcoma is a surface lesion without evidence of medullary involvement. This report extends the Mayo Clinic series of periosteal osteosarcoma cases from 11 to 22 cases. In a review of demographic information from our 22 cases and from 30 additional cases, referred only for pathologic diagnosis, the average age at the time of diagnosis in our series was 20.5 years. The proximal tibia was the most frequent site of tumor. Men and women were affected in approximately equal numbers. Limb pain and swelling were common complaints, as were findings of limb mass and tenderness. Excision of a tumor demands at least wide margins. When surgical margins were less than wide, there were higher rates of local tumor recurrence and tumor metastasis. A relatively high rate of tumor recurrence and metastasis occurred with femoral lesions despite wide excisional margins, suggesting that femoral lesions may need more aggressive surgical treatment.