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Osteosarcoma
How is osteosarcoma diagnosed?
Currently, the diagnosis of osteosarcoma in clinical settings primarily relies on a combination of clinical symptoms, imaging studies, and pathological findings. Clinically, osteosarcomas commonly occur in the distal femur, proximal tibia, and lower end of the humerus, manifesting as localized persistent pain, nocturnal pain, and swelling, often accompanied by superficial venous engorgement and increased skin temperature. Systemic symptoms of cachexia may appear, and even pathological fractures. Imaging is indispensable, revealing osteoblastic, osteolytic, or mixed osteolytic lesions, usually with a pronounced periosteal reaction, Codman's triangle (a common sign of malignancy), or sunburst patterns. Magnetic resonance imaging (MRI) is very important for diagnosing bone tumors as it can indicate the tumor's boundaries and the extent of erosion. Additionally, PET-CT and radioactive isotope scanning are considered crucial for tumor diagnosis. Pathological examination is currently regarded as the gold standard for diagnosing osteosarcoma. This involves a biopsy, usually taking a small part of the tumor for examination from a molecular biology perspective. However, when performing a biopsy, it is important to note two things: first, it is preferable to take the biopsy intraoperatively; second, if there is no plan for systematic treatment of osteosarcoma, it is best not to proceed with a biopsy to avoid potentially accelerating the spread or even hastening metastasis. Therefore, the diagnosis of osteosarcoma must be approached with caution, requiring a combination of clinical symptoms, necessary auxiliary examinations, and pathological analysis.
Characteristics of bone metastasis in osteosarcoma
Osteosarcoma, when it metastasizes to the bone, is very complex to treat. Surgery cannot fully excise the metastasized bone tissue. Currently, clinical treatments mainly involve a comprehensive approach using radiotherapy, chemotherapy, and traditional Chinese medicine. Most osteosarcomas show improvement in symptoms and an increase in patients' quality of life after radiotherapy and chemotherapy treatment. However, these treatments have their complications. For instance, while killing tumor cells, they can also damage normal cells, resulting in a decreased immune response and various related complications. Ultimately, this might lead to the cessation of radiotherapy and chemotherapy treatments. Therefore, current treatments for bone metastases from osteosarcoma involve using radiotherapy and chemotherapy in conjunction with traditional Chinese medicine. Traditional Chinese medicine may enhance the efficacy of radiotherapy and chemotherapy while also reducing their toxicity. (The use of medications should be under the guidance of a professional doctor.)
Can osteosarcoma be detected by ultrasound?
Osteosarcomas are generally difficult to diagnose through ultrasound. The diagnosis of osteosarcoma mainly relies on the following methods. The first method is X-rays. X-rays can reveal a typical Codman's triangle appearing in the bone. The second method involves using CT and MRI to detect the extent of the tumor and to see if there is extensive infiltration around it. The third method is nuclear bone scanning. The main significance of nuclear bone scanning is to detect bone tumors early and to distinguish whether there has been any metastasis in the later stages. The fourth method is the gold standard, which is to perform a biopsy. However, this test is invasive, requiring the cutting of tissue from the osteosarcoma for pathological examination. Of course, this method provides the highest accuracy and positive rate.
osteosarcoma X-ray presentation
The variations in the X-ray appearance of osteosarcoma are quite large, but the basic characteristics are a mix of osteolytic destruction and pure bony changes. In most cases, besides the mixed changes, there is also destruction of the bone cortex and invasion of soft tissues, with visible periosteal reaction. The epiphysis has a certain blocking effect on the tumor, hence it rarely crosses the epiphyseal line. On the X-ray, changes indicative of skip metastasis can be seen, along with typical Codman's triangle or sunburst patterns. Beneath the periosteum, there are fine, needle-like sunburst radiating changes, which are fairly typical radiographic changes of osteosarcoma and are generally used to diagnose the condition.
Causes of Osteosarcoma Formation
The causes of osteosarcoma formation are currently unclear in clinical practice, but they are somewhat related to environmental factors and genetic changes, including heredity. If triggered by external viral infections or physical and chemical influences, osteosarcomas may develop. Likewise, genetic mutations and cellular mutations might also be associated with the formation of osteosarcomas. Osteosarcomas originate from mesenchymal cells and can grow rapidly; passing through a cartilaginous stage, they directly and indirectly form bone-like and bone tissues, damaging the bone structure, which leads to severe consequences.
What is osteosarcoma?
Osteosarcoma is a type of malignant tumor that occurs in the bones, generally classified as stage IIb. Common sites for osteosarcoma include the distal part of the bone, the proximal tibia, and the proximal humerus. It most commonly affects adolescents. Clinically, it primarily presents as persistent pain, including nighttime pain. Swelling and limited joint function typically occur around the common sites. Additionally, there are general symptoms associated with cachexia, such as malnutrition, anemia, mild or high fever, or weight loss. Fourthly, it is very prone to causing pathological fractures. Many osteosarcoma patients seek medical attention due to these fractures. Thus, osteosarcoma is a serious malignancy in the bones with a generally poor prognosis. Diagnosis and treatment of osteosarcoma are crucial; upon confirmation, timely treatment is necessary. The primary treatment approach is a combination therapy centered around surgery, typically involving preoperative chemotherapy, followed by surgical treatment and postoperative chemotherapy. Currently, the five-year survival rate for osteosarcoma has significantly improved, reaching approximately 70% to over 80%.
Osteosarcoma is a type of cancer.
Osteosarcoma is a relatively common type of malignant bone tumor in clinical practice. It mainly occurs near the ends of the humerus, including the area around the head of the humerus, and at the distal end of the femur, near the femoral condyles, as well as the proximal tibia, close to the tibial plateau. These are its common sites. It predominantly affects teenagers, generally those under 18 years of age. The main symptoms include: firstly, persistent and worsening pain that gradually intensifies and does not alleviate, with the notable characteristic being that the pain is more severe at night than during the day; secondly, the appearance of spindle-shaped tumors around the joints, particularly at the three aforementioned common sites, often accompanied by redness, warmth, pain in the superficial skin, and even prominent superficial veins; thirdly, osteosarcoma is a type of malignant tumor, classified as grade 2B among malignant tumors. Its main feature, apart from local symptoms, is its propensity for metastasis, with the lungs being the most likely site of metastasis.
How big do osteosarcomas generally grow?
The size of osteosarcoma is generally difficult to measure. By undergoing radiographic examination, Codman's triangle and bone destruction can be observed in the patient's images, which can be diagnosed as osteosarcoma. Further biopsy is then required. Osteosarcoma typically presents as a mass approximately the size of a fist, and early stages may involve malignant pulmonary metastasis. By conducting a pulmonary CT scan, lesions and metastatic foci can be discovered, primarily indicating bone destruction and the presence of Codman's triangle. Such destruction can deform the normal bone structure, and abnormal masses may be palpable during physical examinations, presenting in irregular shapes. This condition is commonly seen and cannot be evaluated merely by the size of the osteosarcoma. Early stages may involve lung metastasis, progressing to advanced stages where the prognosis is poor and survival rates significantly decrease. Therefore, this disease generally requires early diagnosis and treatment.
Can osteosarcoma be cured?
Osteosarcoma is a malignant tumor of the bone, commonly occurring in adolescents and young adults, primarily near the proximal end of the tibia, the distal ancient end, or near the proximal end of the humerus, most frequently seen at the end of the bone shaft. In the early stages, there are no symptoms, and once detected, it is usually in the middle to late stages. An X-ray examination can be used for diagnosis, often showing a Codman's triangle or a sunburst pattern. Osteosarcoma generally needs early detection and treatment. If a primary lesion is present, surgical treatment can be pursued, including procedures such as resection with inactivation and reimplantation or limb-sparing surgery with a prosthesis. Another option is amputation, followed by extensive chemotherapy. The likelihood of osteosarcoma spreading to the lungs is very high. In recent years, with early diagnostic physical examinations and the rapid development of chemotherapy, the five-year survival rate for osteosarcoma can reach 50%.
How long is the latent period of osteosarcoma?
In clinical practice, there is no such thing as a latency period for malignant bone tumors, because these tumors progress very quickly. So, if you experience symptoms such as swelling and pain in the affected limb, if you can feel a mass, and if the pain severely impacts your daily life, you should promptly go to a hospital to get an imaging test done to determine whether a bone tumor is present. Only through imaging and accurate diagnosis can early diagnosis and treatment be achieved, which is the best treatment approach for osteosarcoma. Therefore, in clinical practice, there is no concept of a latency period for malignant bone tumors.