Osteosarcoma

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Written by Wang Cheng Lin
Orthopedics
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Do osteosarcomas hurt?

The early symptoms of osteosarcoma include pain, which initially is intermittent. As the condition progresses, this intermittent pain gradually becomes constant, and the intensity of the pain is parallel to the severity of the osteosarcoma, meaning the more severe the osteosarcoma, the more intense the pain. Additionally, you can also feel a lump forming on the affected limb, and this lump is clearly tender to touch. The third symptom is the occurrence of a limp. This limp is due to pain, which prevents the patient from bearing weight and walking for extended periods. Lastly, all osteosarcomas present symptoms such as anemia, pathologic fractures, and a low-grade fever.

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Written by Na Hong Wei
Orthopedics
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Can osteosarcoma be felt?

Osteosarcoma can be felt by touch, and its main clinical manifestations include persistent progressive pain, which intensifies at night. Secondly, there are local lumps, commonly located at the distal femur, proximal tibia, and proximal humerus, which are high incidence areas for osteosarcoma. In such cases, you don't even need to touch it; you can see it with the naked eye because the swelling is quite severe. Additionally, the surrounding skin may appear reddened and warm, and superficial veins may become prominently swollen, indicating that the skin over the affected area looks different from normal skin. Moreover, in the area affected by osteosarcoma, the bone may show a spindle-shaped enlargement, looking like a spindle-shaped lump, causing the joint area and the surrounding normal joints to be clearly abnormal. Therefore, in cases of obvious symptoms of osteosarcoma, not only can you see the tumor, but you can also feel it. However, patients often will not let you touch it, as touching can cause pain and even force the joint and surrounding muscles into a forced state. This forced condition helps alleviate pain in the joint and surrounding areas. Thus, osteosarcoma can indeed be felt by touch.

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Written by Guan Yu Hua
Orthopedic Surgery
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What does osteosarcoma feel like to the touch?

Osteosarcoma is a malignant tumor that consumes bone and typically shows no symptoms in its early stages. By the time symptoms are recognized, it is usually in the mid to late stages. There might be localized masses; upon discovery of such masses, a visit to the hospital for diagnostic imaging is needed. Radiological examinations reveal characteristic signs such as sunburst appearance and Codman's triangle on X-rays. Further investigation with MRI or CT scans is necessary, followed by a biopsy for confirmation. During physical examination for this type of osteosarcoma, a localized mass may be found typically around the proximal tibia or distal femur, mainly around the metaphyseal ends. The mass may be accompanied by localized heat and pain, with nocturnal pain being more pronounced. Additionally, patients might show varying degrees of weight loss. Generally, osteosarcoma can be diagnosed through physical examination and radiological findings, followed by a confirmatory biopsy. Early stages require surgical intervention. Furthermore, osteosarcomas have a high rate of early pulmonary metastasis. Using extensive chemotherapy can improve patient survival time. With rapid advancements in chemotherapy, the five-year survival rate can reach about 50%.

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Written by Wang Cheng Lin
Orthopedics
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Osteosarcoma can exhibit which symptoms?

The symptoms of osteosarcoma, first of all, include pain. The severity of the tumor varies, and so does the accompanying pain. If the tumor significantly damages the bone, causing stimulation to the nerve endings of the periosteum, it will lead to increased pain; Secondly, there is a lump. A lump can be felt on the limb, but this lump also comes with significant tenderness. The growth rate of this lump depends on the condition; Third, there is limping. This limping is also due to limb pain, which causes progressive limping symptoms when walking, and prolonged limping can also lead to joint stiffness and muscle atrophy; Fourth, there are systemic symptoms. Any patient with malignant tumors will experience weight loss, anemia, and multi-organ failure, and may even suffer from pathological fractures.

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Written by Guan Yu Hua
Orthopedic Surgery
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Can late-stage osteosarcoma be cured?

For osteosarcoma in its late stages, it often metastasizes to other organs, with the majority of cases involving lung metastasis. In such cases, conservative treatment can be applied. However, if surgery is an option, it is the best approach as it can be complemented with postoperative chemotherapy and radiotherapy to extend the patient’s survival time. If there is distant metastasis and the body is in poor condition, unable to withstand surgery, then only conservative treatment and nutritional support are viable, along with the use of painkillers. In late stages, when the patient cannot tolerate surgery, only conservative treatment is available with no other alternatives. Typically, the conditions are divided into three stages. By stage three, there is usually lung metastasis. This stage often involves T which signifies intracompartmental or extracompartmental growth—T2 indicating extracompartmental, typically a marker of an aggressive tumor. Then M represents metastasis, with 0 for none and 1 for presence. So, in cases where distant metastasis occurs, it generally corresponds to stage three, phase B, which involves extracompartmental invasive metastasis. In such cases, even surgery provides poor outcomes. Early detection and treatment are best. If it progresses to later or final stages, treatment is often deemed unnecessary, limited to conservative management, as surgical outcomes are poor, and metastasis may occur elsewhere.

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Written by Wang Cheng Lin
Orthopedics
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Will osteosarcoma cause the skin to turn red?

Patients with osteosarcoma will not have red skin. The early symptoms of osteosarcoma are generally not obvious, primarily involving localized swelling, with pain around the joints leading to limited joint mobility. As the condition progresses, this pain may shift from intermittent to constant, and the severity of the pain will increase as the disease worsens. The second patient will exhibit a noticeable lump that can be felt; this lump is usually accompanied by significant tenderness. The third symptom is intermittent limping, caused by pain from the tumor during walking, which prevents the patient from bearing weight for extended periods. The fourth aspect involves systemic symptoms common to patients with tumors, such as anemia, mild fever, and even pathological fractures.

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Written by Guan Jing Tao
Orthopedics
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Can patients with osteosarcoma have children?

Whether osteosarcoma patients can have children requires comprehensive consideration. One factor is that the patient's age should not be too old. Additionally, one must consider the individual's response after surgery and subsequent performance after treatment. Besides, regular check-ups should be conducted, and attempts to conceive can be made if there is no obvious abnormality or other pathological changes in the body. However, it is essential to conduct regular follow-ups and be mentally prepared. The possibility of various problems during pregnancy should not be ruled out, such as a decrease in immune response, which could trigger a recurrence of the bone tumor or other conditions, potentially leading to health issues for the child or the mother. Thus, a comprehensive and thorough evaluation is necessary.

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Written by Guan Yu Hua
Orthopedic Surgery
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Can osteosarcoma be treated with moxibustion?

Osteosarcoma is a malignant tumor of the bone, and the treatment effect of moxibustion is not very good. This disease develops quite rapidly, mostly occurring at the proximal end of the tibia, the distal end of the femur, the proximal end of the humerus, among others, typically at the metaphyseal ends. Clinically, the main symptoms include persistent pain, which becomes more pronounced at night, along with local swelling, restricted movement, increased local surface skin temperature, some may show prominent veins, and patients often appear emaciated, severely looking cachectic as the disease progresses with noticeable symptoms. Radiographic examination can reveal Codman's triangle or sunburst patterns. Early detection necessitates early treatment, including surgery such as inactivation reimplantation or prosthesis implantation to sustain operation. Additionally, amputation followed by extensive chemotherapy can effectively improve the patient’s survival time. Osteosarcoma has a high chance of early pulmonary metastasis, requiring systematic treatment at a hospital. Solely using moxibustion is not very effective and has limited usefulness, but it could still be worth a try if there are no better options available.

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Written by Wang Cheng Lin
Orthopedics
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What tests are done to diagnose osteosarcoma?

The most accurate diagnostic method for osteosarcoma is biopsy, where live tissue is extracted and sent for pathological examination. The positive rate of this method can reach over 90%. Besides biopsy, there are several other methods to examine such conditions. For example, X-rays can be taken to observe significant damage to the bone structure. Secondly, CT scans and MRI can be used to determine whether the bone tumor has infiltrated surrounding tissues. MRI can also detect if there are metastases to organs outside the lungs. The third method is radionuclide bone scanning, which primarily aims to check for distant metastases of osteosarcoma.

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Written by Wang Cheng Lin
Orthopedics
48sec home-news-image

Osteosarcoma etiology

Currently, in clinical practice, the pathogenesis of osteosarcoma is not fully understood. However, it may be related to genetics, exposure to radioactive materials, and viral infections. It can also be secondary to other deformative osteitis, fibrous dysplasia, and some benign tumors transforming into malignant bone tumors. Osteosarcoma primarily occurs in the metaphysis of long bones. The tumor spreads along the marrow cavity, extending towards both the metaphysis of the long bones and the diaphysis of the bones. Once the tumor breaks through the bone shaft, it rapidly destroys the cortical bone, spreads under the periosteum, and invades the surrounding soft tissues outside the eardrum, damaging the surrounding muscles and soft tissues.