Tumors of periosteal origin

UKPRISING AS IT MAY SEEM, there appears to S be no comprehensive discussion on record of tumors developing within periosteal connective tissue, although there have been reports of unusual cases or of small groups of cases demonstrating the characteristic features of some particular periosteal tumor or other.These comparatively uncommon neoplasms constitute a group unto themseltes, and their pathological traits and clinical behwior must he determined empirically, rather than inferred by analogy.The behavior of a periosteal fibrosarcoma, for example, cannot be predicted Lrom that of a central fibrosarcoma of bone.It is only in recent years that the field has been explored to any significant degree, and there is still much to be ascertained, as will be indicated presently.The main purpose ol this paper is to survey and integrate the limited information now available and to highlight certain practical problems in diagnosis and treatment that require further clarification.In particular, the significance of cartilaginous and/or osseous metaplasia of periosteal connective tissue leading to the formation of juxtacortical tumorlike masses and the incidence of eventual malignant change in such lesions will be considered.Specific reference will also be made to periostcaI fibroma, neurofibrorna, lipoma, and chondroma as the major benign tumors in point, and to fibrosarcoma, chondrosarcoma, and osteogenic sarcoma as the malignant ones.It is altogether probable that on rare occasions neoplasms of other types may arise from the periosteum, but too little is known about their incidence to serve as a basis for discussion.Mention should also be made in passing of pseudotumors on the surface of affected bones