Bertoni F, Boriani S, Laus M, Campanacci M
J Bone Joint Surg Br. 1982;64(3):370-6. doi: 10.1302/0301-620X.64B3.7096408.
This review of 27 cases serves to emphasis that periosteal chondrosarcoma and periosteal osteosarcoma are two distinct entities. Clinically, periosteal chondrosarcoma is less painful than periosteal osteosarcoma and runs a slower course. Radiographically, periosteal chondrosarcoma tends to affect the metaphysis and contains granular or "popcorn" opacities; while periosteal osteosarcoma more often affects the mid-diaphysis and shows lytic lesions with some spicules of reactive bone perpendicular to the underlying cortex. Histologically, periosteal chondrosarcoma shows lobular well-differentiated cartilage with Grade I or II (rarely Grade III) malignancy; periosteal osteosarcoma has a chondroid matrix with some osteoid component and Grade II or III malignancy. The prognosis in periosteal chondrosarcoma is good; conservative surgery is usually effective and metastases are very uncommon. In periosteal osteosarcoma the prognosis is less satisfactory but is better than that of other osteosarcomata; wide surgical excision is, however, needed and the incidence of metastases is about 15 per cent.
对27例病例的这项综述旨在强调骨膜软骨肉瘤和骨膜骨肉瘤是两种不同的实体。临床上，骨膜软骨肉瘤比骨膜骨肉瘤疼痛轻，病程进展较慢。影像学上，骨膜软骨肉瘤倾向于累及干骺端，含有颗粒状或“爆米花”样不透光区；而骨膜骨肉瘤更常累及骨干中段，表现为溶骨性病变，伴有一些垂直于下方皮质的反应性骨针。组织学上，骨膜软骨肉瘤表现为小叶状高分化软骨，恶性程度为I级或II级（很少为III级）；骨膜骨肉瘤有软骨样基质，伴有一些骨样成分，恶性程度为II级或III级。骨膜软骨肉瘤的预后良好；保守手术通常有效，转移非常罕见。骨膜骨肉瘤的预后不太令人满意，但比其他骨肉瘤要好；然而，需要广泛的手术切除，转移发生率约为15%。
