Osteosarcoma diagnostic methods

Written by Na Hong Wei
Orthopedics
Updated on September 07, 2024
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Osteosarcoma Diagnostic Methods: In clinical practice, once osteosarcoma is suspected in a patient, the diagnostic approach, as per the Chinese Cancer Treatment Guidelines, requires a combination of clinical symptoms, radiological data, and pathology. Only through the integration of these three elements can a definitive diagnosis of osteosarcoma be established. Reliance solely on pathology, or exclusively on radiologic examination or clinical examination, can lead to biased results. Given that immediate treatment is crucial upon the discovery of osteosarcoma, and considering the severe implications of treatment costs, patient suffering, and other related issues, it is vital that the diagnosis of osteosarcoma is error-free. To ensure absolute certainty, the approach should involve clinical symptoms supplemented by necessary auxiliary examinations such as X-rays and CT or MRI scans, followed by a diagnostic biopsy for pathological results. This comprehensive combination generally prevents the occurrence of missed or misdiagnoses in patients with osteosarcoma. Therefore, the confirmatory diagnosis of osteosarcoma should not rely solely on one type of examination but should combine clinical assessment with necessary imaging data and pathology to finalize the diagnosis process.

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Written by Na Hong Wei
Orthopedics
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What are the symptoms of osteosarcoma?

Osteosarcoma is a very common malignant tumor, primarily occurring at the distal femur, proximal tibia, and proximal humerus. Its manifestations mainly include persistent pain at these three locations, which gradually worsens and is accompanied by nighttime pain. Secondly, there is local swelling; the surface of the tumor may feel warmer to the touch and may even exhibit prominent veins, leading to restricted joint movement near the tumor. Thirdly, some patients may exhibit signs of systemic deterioration, such as weight loss, anemia, and fatigue. Fourthly, osteolytic osteosarcomas often erode the bone cortex, eventually weakening the bone and leading to pathological fractures. Thus, the symptoms of osteosarcoma include persistent pain in specific areas accompanied by nighttime pain, local swelling, systemic deterioration, and pathological fractures in many patients.

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Written by Kuang Tao
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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Can osteosarcoma occur on the knee?

Can osteosarcomas grow on the knee? In fact, the locations where osteosarcomas commonly appear are indeed near the knee. There are mainly three common sites: the most prevalent is the distal end of the femur, the lower part of the thigh bone. The second most common site is the proximal end of the tibia. The third is the proximal end of the humerus. Therefore, osteosarcomas usually do grow near the knee. What are the symptoms of an osteosarcoma? The symptoms of osteosarcoma include, first, localized pain, which is a constant pain that persists, worsens, and does not alleviate, often causing night pain, and many patients do not feel pain during the day, only at night. The second symptom is a localized lump, generally spindle-shaped, with an increased skin temperature over the surface, and even distended veins due to the tumor restricting nearby joint movement. The third symptom is the appearance of cachexia or wasting syndrome throughout the body. The fourth point is that the growth of the osteosarcoma leads to erosion of the bone and eventually pathologic fractures. Thus, the likelihood of osteosarcomas appearing near the knee is very high, and many patients typically come to the hospital because of painful lumps near the knee, and then, after examination, the diagnosis is confirmed.

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Written by Na Hong Wei
Orthopedics
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Is there a cure for osteosarcoma?

Osteosarcoma is treatable, but it requires proper medical treatment. Currently, adjuvant chemotherapy significantly improves the five-year survival rate for osteosarcoma. The main treatment approach is still surgery as part of a comprehensive therapy. Specifically, the first step involves adequate preoperative chemotherapy, generally no fewer than six sessions over about eight weeks, or approximately two months. After this, patients often experience reduced pain, weight gain, improved positioning of the tumor, and a decrease in tumor size. Depending on the specific situation, a decision is made on the type of surgery to be performed—whether to amputate, preserve the limb, install a prosthetic, or use artificial bone as a replacement. Postoperative chemotherapy is usually also required to help ensure that the tumor does not recur and to increase the five-year or ten-year survival rate. Therefore, the current five-year survival rate for osteosarcoma has increased from the previous 40%-50% to about 80%. So, as long as one chooses the right hospital and the right treatment plan, and maintains confidence, osteosarcoma is usually treatable.