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Osteosarcoma
The main metastasis pathways of osteosarcoma
Osteosarcoma is a primary tumor of bone tissue. The tumor can metastasize through the bloodstream, lymphatic system, or nearby tissue. The most common site of metastasis for osteosarcoma clinically is to the lungs. Therefore, it is often recommended that patients undergo chest X-rays or even chest CT scans to detect any metastasis to the lungs.
Symptoms of osteosarcoma recurrence
Osteosarcoma is a relatively common type of malignant bone tumor, ranking second in incidence among malignant bone tumors. Typically, upon the development of osteosarcoma, surgery is required to scrape out the tumor focus, followed by limb-sparing or amputation surgery. Additionally, adjuvant radiotherapy and chemotherapy are employed. Generally, the local area may be maintained for a period, but the disease is prone to recurrence. There may be local recurrence at the site of surgery or distant recurrence, meaning tumor cells might seed and lead to tumors in other locations. Symptoms of both local and distant recurrences are similar to those at the initial onset, generally including significant pain, night pain, and rest pain. There will also be distinct X-ray signs of osteosarcoma in the bone. Furthermore, osteosarcoma may metastasize to the lungs, potentially causing symptoms such as cough, bloody sputum, phlegm, and fever—typical signs of intrapulmonary tumors. These are some of the common symptoms associated with the recurrence of osteosarcoma.
Osteosarcoma mainly metastasizes through
The main metastatic pathways of osteosarcoma are generally divided into three types. The first is hematogenous spread, which refers to the dispersal of tumor cells throughout the body via the bloodstream, typically settling in areas with slower blood flow which facilitates the deposition of these cells leading to local changes. The second is direct implantation, which involves tumor cells directly establishing themselves in the vicinity of the tumor's common sites, eventually leading to local metastasis. The third type is lymphatic spread, where tumor cells migrate through the lymphatic system, spreading along lymphatic vessels or pathways. Therefore, the main metastatic pathways of osteosarcoma are these three types. The primary sites of metastasis for osteosarcoma are mainly the lungs, but metastases can also occur in the brain or through other mechanisms.
Is osteosarcoma a cancer?
If we are to speak strictly, osteosarcoma is not cancer. This is because cancer typically refers to malignant tumors of epithelial tissue, whereas osteosarcoma, like all sarcomas, is a malignant tumor that occurs in connective or muscle tissue. Therefore, their origins are different: osteosarcoma is not cancer; it is a malignant tumor that occurs in bone tissue, commonly found in the distal femur, proximal tibia, and proximal humerus. So, strictly speaking, osteosarcoma is a sarcoma, a malignant tumor that occurs in bone tissue. It is not what one would typically refer to as cancer, which usually pertains to epithelial tissues, such as in cases of skin cancer or breast cancer. Osteosarcoma is therefore classified as a sarcoma, not as cancer.
Is osteosarcoma sensitive to chemotherapy?
Osteosarcoma is relatively sensitive to chemotherapy. Currently, the treatment of malignant tumors is primarily a comprehensive approach centered around surgery. However, the treatment of osteosarcoma should start with neoadjuvant chemotherapy, which involves administering a certain number of chemotherapy sessions, generally around six, before surgery. After chemotherapy, the tumor itself shrinks in size, pain is reduced, and the patient's cachexia also improves. At this point, choosing an optimal surgical method based on the tumor’s location and size becomes feasible, whether it involves amputation, limb-salvage, or other treatment methods such as the implantation of prosthetics. Postoperative chemotherapy is then administered. With this approach, there is a significant improvement in the five-year survival rate. Therefore, the treatment of osteosarcoma is inseparable from chemotherapy, requiring both preoperative and postoperative chemotherapy, making osteosarcoma quite sensitive to chemotherapy overall.
The difference between sarcoma and osteosarcoma
The relationship between sarcoma and osteosarcoma is very simple; it is a relationship of containment where sarcoma includes osteosarcoma. Simply put, the concept of sarcoma is broader, and osteosarcoma is a subtype under it. Sarcoma itself also includes malignant tumors occurring in blood vessels, fat, nerves, and muscles, such as angiosarcoma, liposarcoma, rhabdomyosarcoma, and leiomyosarcoma, and, of course, osteosarcoma. However, both sarcoma and osteosarcoma are malignant tumors, and it's important to clarify this concept. Moreover, osteosarcoma is more common in young people.
Is osteosarcoma treatable?
Osteosarcoma is not about whether it can be treated, but it must be treated. Moreover, the earlier the treatment, the higher the five-year survival rate. Currently, the treatment for osteosarcoma still primarily involves comprehensive therapy centered around surgery. With the advent of neoadjuvant chemotherapy, the five-year survival rate for osteosarcoma has significantly increased. Specifically, once osteosarcoma is diagnosed, extensive chemotherapy is administered before surgery. After chemotherapy, depending on the extent of tumor invasion, either radical segmental resection, limb-sparing surgery, or amputation is considered. Postoperative treatment also requires continued high-dose chemotherapy. In fact, if osteosarcoma is not treated, it metastasizes very quickly, primarily to the lungs. However, if the treatment is very early, timely, and correct, the current five-year survival rate has reached about 80%. Therefore, osteosarcoma can be treated, and the earlier the treatment, the better the outcomes.
What is osteosarcoma?
Firstly, osteosarcoma is a common type of malignant tumor, characterized by a mechanism that produces bone-like tissue. It has multiple subtypes and can also develop into a secondary osteosarcoma. Secondly, it commonly occurs in adolescents. Thirdly, it typically affects the proximal femur, distal tibia, and proximal humerus. Fourthly, common osteosarcomas are generally spindle-shaped, often located near joints. The surface may have elevated skin temperature and sometimes superficial vein distension is apparent. It often involves the entire bone, including the periosteum, cortical bone, and bone cavity. Generally, the tumor appears as a very fine greyish-white or brownish-red fish-flesh-like change. Osteosarcoma is a malignant tumor and is particularly prone to lung metastasis. According to tumor staging, it is at least stage IIB, indicating that it should be detected, diagnosed, and treated early. The earlier the treatment, the better the outcome and the higher the five-year survival rate.
Is osteosarcoma highly malignant?
First of all, it is certain that osteosarcoma is very malignant. Once osteosarcoma is detected, it is necessary to actively prepare for surgery, rule out surgical contraindications, and then proceed with surgical treatment. During the surgery, efforts should be made to perform an extended resection, and if necessary, amputation may be required. After the surgery, the excised specimen must be sent for pathological examination to determine the pathological type. Then, based on the examination results, effective radiotherapy and chemotherapy should be chosen to control the possibility of recurrence or metastasis of osteosarcoma and to extend the patient's life as much as possible.
What are the symptoms of osteosarcoma?
The main symptom of osteosarcoma is localized pain, primarily at the distal end of the femur, the proximal end of the tibia, and the proximal end of the humerus. This pain tends to worsen continuously, with nighttime pain often more severe than during the day, which is a significant characteristic of osteosarcoma. The second symptom is the presence of a local mass, which is often spindle-shaped and generally located near a joint. This mass often leads to limited joint mobility, and the skin over the mass typically has a high temperature. Sometimes, it may also be accompanied by visible swelling of superficial veins. The third symptom involves systemic cachexia, which includes unexplained weight loss, generalized weakness, and even an anemic condition. The fourth point pertains to osteolytic osteosarcoma, which often leads to bone destruction, reduced bone strength, and consequently, even minor external forces can cause fractures. These are called pathological fractures. Thus, the symptoms of osteosarcoma generally include these four points.