What are the symptoms of osteosarcoma?

Written by Na Hong Wei
Orthopedics
Updated on September 10, 2024
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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 Na Hong Wei
Orthopedics
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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.

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Written by Na Hong Wei
Orthopedics
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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.

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Written by Wang Cheng Lin
Orthopedics
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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.

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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 Guan Yu Hua
Orthopedic Surgery
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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.