Osteosarcoma is a type of cancer.

Written by Na Hong Wei
Orthopedics
Updated on January 22, 2025
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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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What is osteosarcoma?

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 Na Hong Wei
Orthopedics
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How is osteosarcoma diagnosed?

Currently, the diagnosis of osteosarcoma in clinical settings primarily relies on a combination of clinical symptoms, imaging studies, and pathological findings. Clinically, osteosarcomas commonly occur in the distal femur, proximal tibia, and lower end of the humerus, manifesting as localized persistent pain, nocturnal pain, and swelling, often accompanied by superficial venous engorgement and increased skin temperature. Systemic symptoms of cachexia may appear, and even pathological fractures. Imaging is indispensable, revealing osteoblastic, osteolytic, or mixed osteolytic lesions, usually with a pronounced periosteal reaction, Codman's triangle (a common sign of malignancy), or sunburst patterns. Magnetic resonance imaging (MRI) is very important for diagnosing bone tumors as it can indicate the tumor's boundaries and the extent of erosion. Additionally, PET-CT and radioactive isotope scanning are considered crucial for tumor diagnosis. Pathological examination is currently regarded as the gold standard for diagnosing osteosarcoma. This involves a biopsy, usually taking a small part of the tumor for examination from a molecular biology perspective. However, when performing a biopsy, it is important to note two things: first, it is preferable to take the biopsy intraoperatively; second, if there is no plan for systematic treatment of osteosarcoma, it is best not to proceed with a biopsy to avoid potentially accelerating the spread or even hastening metastasis. Therefore, the diagnosis of osteosarcoma must be approached with caution, requiring a combination of clinical symptoms, necessary auxiliary examinations, and pathological analysis.

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Written by Guan Yu Hua
Orthopedic Surgery
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Can osteosarcoma be cured?

Osteosarcoma is a malignant tumor of the bone, commonly occurring in adolescents and young adults, primarily near the proximal end of the tibia, the distal ancient end, or near the proximal end of the humerus, most frequently seen at the end of the bone shaft. In the early stages, there are no symptoms, and once detected, it is usually in the middle to late stages. An X-ray examination can be used for diagnosis, often showing a Codman's triangle or a sunburst pattern. Osteosarcoma generally needs early detection and treatment. If a primary lesion is present, surgical treatment can be pursued, including procedures such as resection with inactivation and reimplantation or limb-sparing surgery with a prosthesis. Another option is amputation, followed by extensive chemotherapy. The likelihood of osteosarcoma spreading to the lungs is very high. In recent years, with early diagnostic physical examinations and the rapid development of chemotherapy, the five-year survival rate for osteosarcoma can reach 50%.

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of osteosarcoma?

Symptoms of Osteosarcoma: The first is pain at the site of occurrence. This pain may be intermittent and not very pronounced in the early stages. As the condition progresses, the severity of the pain gradually increases, transitioning from intermittent to persistent pain; The second is the formation of a lump. You can feel a lump on the limb with your hand, and this lump is clearly tender to the touch; The third is limping, which is mainly caused by the pain in the limb; The fourth is the most common systemic symptoms. Patients with this malignant tumor will exhibit fever, weight loss, anemia, and pathological fractures. These are the main symptoms of osteosarcoma currently observed in clinical settings.

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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.