What is osteosarcoma?

Written by Na Hong Wei
Orthopedics
Updated on September 22, 2024
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Firstly, osteosarcoma is a common type of malignant tumor, characterized by a mechanism that produces bone-like tissue. It has multiple subtypes and can also develop into a secondary osteosarcoma. Secondly, it commonly occurs in adolescents. Thirdly, it typically affects the proximal femur, distal tibia, and proximal humerus. Fourthly, common osteosarcomas are generally spindle-shaped, often located near joints. The surface may have elevated skin temperature and sometimes superficial vein distension is apparent. It often involves the entire bone, including the periosteum, cortical bone, and bone cavity. Generally, the tumor appears as a very fine greyish-white or brownish-red fish-flesh-like change. Osteosarcoma is a malignant tumor and is particularly prone to lung metastasis. According to tumor staging, it is at least stage IIB, indicating that it should be detected, diagnosed, and treated early. The earlier the treatment, the better the outcome and the higher the five-year survival rate.

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Written by Fang Da Zheng
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Are osteosarcomas sensitive to radiotherapy and chemotherapy?

Osteosarcoma is generally insensitive to radiotherapy, hence radiation therapy is not used for such diseases in clinical settings. Similarly, these diseases have a moderate sensitivity to chemotherapy, necessitating the use of relatively high doses of chemotherapy during treatment. The main mechanism of chemotherapy involves using a series of cytotoxic drugs to inhibit tumor growth. Although high-dose chemotherapy can effectively kill tumor cells, it can also damage some of the patient's normal cells, leading to severe reactions. If radical surgery is viable for these patients, then curative surgery is the preferred method of treatment.

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Written by Li Jie
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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
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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.

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Written by Guan Yu Hua
Orthopedic Surgery
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What does osteosarcoma feel like to the touch?

Osteosarcoma is a malignant tumor that consumes bone and typically shows no symptoms in its early stages. By the time symptoms are recognized, it is usually in the mid to late stages. There might be localized masses; upon discovery of such masses, a visit to the hospital for diagnostic imaging is needed. Radiological examinations reveal characteristic signs such as sunburst appearance and Codman's triangle on X-rays. Further investigation with MRI or CT scans is necessary, followed by a biopsy for confirmation. During physical examination for this type of osteosarcoma, a localized mass may be found typically around the proximal tibia or distal femur, mainly around the metaphyseal ends. The mass may be accompanied by localized heat and pain, with nocturnal pain being more pronounced. Additionally, patients might show varying degrees of weight loss. Generally, osteosarcoma can be diagnosed through physical examination and radiological findings, followed by a confirmatory biopsy. Early stages require surgical intervention. Furthermore, osteosarcomas have a high rate of early pulmonary metastasis. Using extensive chemotherapy can improve patient survival time. With rapid advancements in chemotherapy, the five-year survival rate can reach about 50%.

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Can late-stage osteosarcoma be cured?

For osteosarcoma in its late stages, it often metastasizes to other organs, with the majority of cases involving lung metastasis. In such cases, conservative treatment can be applied. However, if surgery is an option, it is the best approach as it can be complemented with postoperative chemotherapy and radiotherapy to extend the patient’s survival time. If there is distant metastasis and the body is in poor condition, unable to withstand surgery, then only conservative treatment and nutritional support are viable, along with the use of painkillers. In late stages, when the patient cannot tolerate surgery, only conservative treatment is available with no other alternatives. Typically, the conditions are divided into three stages. By stage three, there is usually lung metastasis. This stage often involves T which signifies intracompartmental or extracompartmental growth—T2 indicating extracompartmental, typically a marker of an aggressive tumor. Then M represents metastasis, with 0 for none and 1 for presence. So, in cases where distant metastasis occurs, it generally corresponds to stage three, phase B, which involves extracompartmental invasive metastasis. In such cases, even surgery provides poor outcomes. Early detection and treatment are best. If it progresses to later or final stages, treatment is often deemed unnecessary, limited to conservative management, as surgical outcomes are poor, and metastasis may occur elsewhere.