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 Li Jie
Orthopedics
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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.

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Written by Li Jie
Orthopedics
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Does osteosarcoma hurt when pressed?

Osteosarcoma, also known as osteogenic sarcoma, is a primary malignant tumor of the bone. It ranks second in incidence among bone tumors and has a relatively high incidence and malignancy rate. It is more common in adolescents and occurs more frequently in males than in females. The earliest clinical symptoms of this disease include dull pain and persistent pain that worsens with activity, as well as nighttime pain, which is more pronounced than daytime pain. This is a very important characteristic, indicating that patients experience nighttime pain and rest pain. The affected area may develop a rapidly growing mass that changes significantly in size from month to month. If the tumor grows large, pressing on it can cause pain, but in the early stages when the tumor is not very large, the tenderness may not be very apparent, presenting only as localized spontaneous pain, which requires attention.

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Written by Na Hong Wei
Orthopedics
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Osteosarcoma diagnostic methods

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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Symptoms of osteosarcoma

The common symptoms of osteosarcoma include, first, pain which is often persistent, typically occurring at the distal femur, proximal tibia, and proximal humerus. The characteristic of this pain is that it worsens at night, more severe than during the day. Second, there is local swelling usually near joints, particularly at the three aforementioned common sites. The skin over the swelling often becomes warm and may even show redness, and some patients may have dilated surface veins. The swelling can frequently cause dysfunction of nearby joints, or restricted function. Third, systemic symptoms primarily include a persistent wasting syndrome, known as cachexia. Fourth, osteosarcomas can weaken the bone's load-bearing capacity and strength following cortical bone involvement, eventually leading to pathological fractures. Therefore, the main symptoms of osteosarcoma are localized pain, local swellings, systemic manifestations of cachexia, or pathological fractures.

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Written by Guan Yu Hua
Orthopedic Surgery
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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%.