Osteosarcoma classification

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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 intramedullry/central and surface osteosarcoma with a number of sub-types under each grou

Classification

Classification of osteosarcoma

Primary osteosarcoma	Conventional-intramedullary/central high grade (most common) further sub-typed as:	Osteoblastic (50%) Chondroblastic (25%) Fibroblastic (25%)
Secondary osteosracomas	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 osteoblastoma 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 b. Telangiectatic osteosarcoma c. Intraosseous well-differentiated (low-grade) osteosarcoma d. Small cell osteosarcoma
SURFACE (PERIPHERAL)	a. Parosteal (juxtacortical) well-differentiated (low-grade) osteosarcoma b. Periosteal osteosarcoma - low- to intermediate-grade osteosarcoma c. High-grade surface osteosarcoma

Osteosarcoma may be classified according to the World Health Organization’s histologic classification of bone tumors into three groups: Central (medullary) tumors:

• Conventional central osteosarcomas.
• Telangiectatic osteosarcomas.
• Intraosseous well-differentiated (low-grade) osteosarcomas.
• Small-cell osteosarcomas.

Surface (peripheral) tumors:

• Parosteal (juxtacortical) well-differentiated (low-grade) osteosarcomas.
• Periosteal osteosarcoma: Low-grade to intermediate-grade osteosarcomas.
• High-grade surface osteosarcomas.

Extraskeletal:

• Extraskeletal osteosarcomas.