Osteosarcoma bone metastasis symptoms

Written by Na Hong Wei
Orthopedics
Updated on September 03, 2024
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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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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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Is chondrosarcoma cancer?

Chondrosarcoma is broadly cancer, but in medical terms, we wouldn’t necessarily phrase it that way; we simply describe chondrosarcoma as a type of malignant tumor, and currently, its treatment outcomes are not very good. Generally, when we talk about cancer, we’re referring to malignant tumors that originate from epithelial tissue, including cancers like stomach cancer, lung cancer, colon cancer, and liver cancer, which all derive from epithelial tissues. However, because chondrosarcoma originates from mesenchymal tissue, which includes muscle, cartilage, blood vessels, and nerves, malignant tumors that occur in these areas are usually called sarcomas. Sarcomas are definitely malignant, but to strictly call them cancer is not particularly precise.

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Characteristics of Osteosarcoma

Osteosarcoma is a malignant tumor of the bone that primarily occurs in adolescents and young adults, commonly found at the metaphyseal ends of long bones. For example, it may occur at the distal end of the tibia, the distal end of the femur, or the metaphyseal end of the humerus. Clinically, the main symptom is pain, which is persistent and more noticeable at night, accompanied by a local mass, limited movement, increased local skin temperature, distended veins, and general symptoms such as weight loss and even cachexia. Some patients may experience pathological fractures. Often, there are no symptoms in the early stages, and by the time it is detected, it is usually in an intermediate or advanced stage. Radiographic examination typically shows a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. The usual treatment choice is surgical, such as deactivation and reimplantation, or limb-salvage surgery with prosthetic implantation. Additionally, amputation followed by extensive chemotherapy is another option. With recent advances in chemotherapy, there has been significant improvement in life extension.

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Osteosarcoma mainly metastasizes through

The main metastatic pathways of osteosarcoma are generally divided into three types. The first is hematogenous spread, which refers to the dispersal of tumor cells throughout the body via the bloodstream, typically settling in areas with slower blood flow which facilitates the deposition of these cells leading to local changes. The second is direct implantation, which involves tumor cells directly establishing themselves in the vicinity of the tumor's common sites, eventually leading to local metastasis. The third type is lymphatic spread, where tumor cells migrate through the lymphatic system, spreading along lymphatic vessels or pathways. Therefore, the main metastatic pathways of osteosarcoma are these three types. The primary sites of metastasis for osteosarcoma are mainly the lungs, but metastases can also occur in the brain or through other mechanisms.

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Can osteosarcoma be felt?

Osteosarcoma can be felt by touch, and its main clinical manifestations include persistent progressive pain, which intensifies at night. Secondly, there are local lumps, commonly located at the distal femur, proximal tibia, and proximal humerus, which are high incidence areas for osteosarcoma. In such cases, you don't even need to touch it; you can see it with the naked eye because the swelling is quite severe. Additionally, the surrounding skin may appear reddened and warm, and superficial veins may become prominently swollen, indicating that the skin over the affected area looks different from normal skin. Moreover, in the area affected by osteosarcoma, the bone may show a spindle-shaped enlargement, looking like a spindle-shaped lump, causing the joint area and the surrounding normal joints to be clearly abnormal. Therefore, in cases of obvious symptoms of osteosarcoma, not only can you see the tumor, but you can also feel it. However, patients often will not let you touch it, as touching can cause pain and even force the joint and surrounding muscles into a forced state. This forced condition helps alleviate pain in the joint and surrounding areas. Thus, osteosarcoma can indeed be felt by touch.