Histopathology report

• tumour type - osteosarcoma/Ewing's sarcoma/chondrosarcoma.

• tumour subtype - parosteal/small cell osteo/chondroblastic, fibroblastic, dedifferentiated.

• tumour grade - osteosarcoma and Ewing's (nearly all are high grade), chondrosarcoma (grade I-III), dedifferentiated.

• tumour necrosis - response as a percentage for an entire slab (applies only to osteosarcoma).

• extent of local tumour spread - medullary cavity/cortex/extra-osseous soft tissues/proximal marrow involvement.

A TNM system is available to help with staging bone tumours but in practice the more simple Enneking system is much more widely used.

Enneking system:

Stage Grade Site

3 Gj or G2 Metastases

T1 intracompartmental

T2 extracompartmental

• lymphovascular invasion including vessel limits.

• excision margins - proximal limit, skin and overlying scars.

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