The difference between sarcoma and osteosarcoma

Written by Peng Li Bo

Oncology

Updated on September 25, 2024

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The relationship between sarcoma and osteosarcoma is very simple; it is a relationship of containment where sarcoma includes osteosarcoma. Simply put, the concept of sarcoma is broader, and osteosarcoma is a subtype under it. Sarcoma itself also includes malignant tumors occurring in blood vessels, fat, nerves, and muscles, such as angiosarcoma, liposarcoma, rhabdomyosarcoma, and leiomyosarcoma, and, of course, osteosarcoma. However, both sarcoma and osteosarcoma are malignant tumors, and it's important to clarify this concept. Moreover, osteosarcoma is more common in young people.

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Osteosarcoma Causes

Osteosarcoma is the most common malignant tumor of the bone and typically presents without symptoms in its early stages. The cause of osteosarcoma is unknown, and it often goes undetected until it has reached a moderate or advanced stage. It commonly develops at the distal end of the femur near the knee joint, at the proximal end of the tibia, or at the proximal end of the humerus, primarily at the end of the growth plate. The pain associated with osteosarcoma is usually persistent, especially severe at night, and can lead to symptoms such as anemia or general wasting. The tumor's surface may be warm to the touch, with prominent veins visible, and radiographic imaging might show a Codman's triangle, indicative of sunlight-like radiation patterns, as well as bone destruction and clear periosteal reaction. Surgical treatment is typically pursued, with amputation being the most common procedure, though limb-sparing surgeries are possible if the tumor is detected early enough. Some cases metastasize, most commonly to the lungs, requiring continued high-dose chemotherapy post-surgery to prolong survival. Generally, the five-year survival rate for osteosarcoma can exceed 50% with early diagnosis and treatment. The chances of survival heavily depend on the individual’s constitution, the timing of tumor detection, and the surgical intervention. The exact causes of osteosarcoma are unclear, and the potential for metastasis complicates treatment. Therefore, early surgical intervention is crucial for improving survival rates and enabling patients to maintain a normal life and work activities.

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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 Na Hong Wei

Orthopedics

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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.

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Written by Na Hong Wei

Orthopedics

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Osteosarcoma bone metastasis symptoms

The symptoms of osteosarcoma metastasis, osteosarcoma most commonly metastasizes to the lungs. If pulmonary metastasis occurs, there are at least two prominent characteristics. The first is that most metastatic tumors are located on the surface of the lungs and are rarely within the lung parenchyma, thus, they are not difficult to detect. The second point is that most metastatic tumors predominantly present as multiple bilateral lung metastases. Isolated unilateral lung metastasis is very rare. Therefore, this characteristic determines that osteosarcoma lung metastasis can only be managed with local wedge-shaped or segmental lung resections as the basic comfort measure. In fact, this simple surgical approach often allows for complete removal of the metastatic tumors while preserving most of the normal lung tissue.

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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.