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Osteosarcoma
Postoperative recurrence symptoms of osteosarcoma
Symptoms of recurrent osteosarcoma after surgery are generally consistent with the symptoms before the initial surgery. The main symptoms include: Firstly, localized pain, which is persistent, progressive, and does not alleviate, including pain that worsens at night. Secondly, localized swelling, which usually occurs around the surgical site if limb-sparing surgery was performed, or at the stump if amputation was done. Thirdly, the appearance of systemic cachexia and symptoms of metastasis. Systemic cachexia typically includes weight loss, anemia, fatigue, and loss of appetite. For osteosarcoma, metastasis primarily targets the lungs, where numerous cancerous shadows can be detected. Thus, the main recurrent symptoms of osteosarcoma after surgery include pain, swelling, and cachexia.
incidence of osteosarcoma
Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone and has a relatively high incidence rate. Among primary bone tumors, the incidence of osteosarcoma is second only to plasma cell myeloma, ranking second. Osteosarcoma typically occurs in tubular bones, commonly affecting the rapidly growing metaphyseal regions. The distal femur, proximal tibia, and proximal humerus are the most frequently affected sites. Between 50%-70% of all cases occur around the knee joint. The common age range for this disease is between 10 to 20 years old, with a higher prevalence in males than in females.
Can hot compresses relieve pain for osteosarcoma?
Osteosarcoma has very limited pain relief effects through simple or pure hot compresses. As the lesion progresses, hot compresses can become completely ineffective or have very unclear effects. Clinical manifestations include pain and swelling, with local formation of lumps or tumor-like appearances. It can also affect the joint mobility around it, and even cause atrophy of limbs and muscles. In terms of treatment, it still relies on early surgical excision, but the prognosis is still not very optimistic.
What is the basis for the diagnosis of osteosarcoma?
Let's briefly describe osteosarcoma, which is a malignant tumor of the bone, most commonly found in adolescents and young adults, typically occurring near the proximal end of the tibia, the distal end of the femur, or the proximal end of the humerus, mainly growing at the epiphyseal ends. In the early stages, patients show no symptoms, with the most common symptom being pain, usually discovered in the middle to late stages. This pain tends to be persistent and is most pronounced at night. Some patients may also have a local mass. Osteosarcomas are highly prone to early lung metastases. Additionally, the surface skin temperature may increase, veins may become distended, and there may be a presence of cachexia as the disease progresses, leading to severe thinness and weakness in the body. The primary diagnostic basis is radiographic examination, which might show unique signs such as Codman’s triangle under sun-ray exposure, indicative of osteosarcoma. If the radiographic signs are not typical, further differentiation can be done using CT scans or MRI. The most crucial matter is surgical biopsy for a definitive diagnosis, mainly based on the postoperative pathology. Intraoperative measures like cryosurgery can be performed. Upon discovery, limb amputation is generally recommended, although limb-sparing surgeries can be considered, involving techniques like resection followed by reimplantation or prosthetic implantation. Overall, the prognosis is typically poor, but with the rapid advancement in chemotherapy, the five-year survival rate can improve somewhat, generally around 50%.
Why is there a cough in osteosarcoma?
Osteosarcoma ranks second in the incidence of malignant tumors in the whole body's bones; its incidence is relatively high. It generally occurs in the long tubular bones, shafts, or epiphyseal areas of the limbs. Since the most common organ metastasis of osteosarcoma is to the lungs, if a patient with osteosarcoma develops a cough, it should be taken seriously, and it's recommended that the patient undergo a targeted examination such as a chest X-ray or a CT scan of the lungs to check for lung metastasis and any lesions on the lungs. However, there is no need to panic prematurely, as osteosarcoma patients might cough due to upper respiratory infections or lung infections, which doesn't necessarily indicate lung metastasis. Therefore, once a patient with osteosarcoma develops a cough, a targeted examination should suffice.
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.