The surgical treatment of parosteal osteosarcoma in long bones.

The cases of twenty-five patients with Stage-I parosteal osteosarcoma were analyzed to ascertain the incidence of recurrence after forty-two various surgical procedures that produced an intracapsular, marginal, wide, or radical excisional margin. Ten intracapsular resections were followed by local recurrence in each patient. This procedure usually was done to shell-out a presumably benign lesion. Marginal excision was successful in nine of seventeen patients. When a marginal excision was knowingly done to preserve a major neurovascular bundle, the risk of recurrence was less (three of eleven) than when it was done to shell-out a presumptively benign lesion (five of six). The fourteen procedures that achieved wide margins obtained local control--that is, there was no recurrence--in each patient. There was one radical procedure without recurrence.