Causes of Osteosarcoma Formation

Written by Wang Cheng Lin
Orthopedics
Updated on January 24, 2025
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The causes of osteosarcoma formation are currently unclear in clinical practice, but they are somewhat related to environmental factors and genetic changes, including heredity. If triggered by external viral infections or physical and chemical influences, osteosarcomas may develop. Likewise, genetic mutations and cellular mutations might also be associated with the formation of osteosarcomas. Osteosarcomas originate from mesenchymal cells and can grow rapidly; passing through a cartilaginous stage, they directly and indirectly form bone-like and bone tissues, damaging the bone structure, which leads to severe consequences.

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Can hot compresses relieve pain for osteosarcoma?

Osteosarcoma has very limited pain relief effects through simple or pure hot compresses. As the lesion progresses, hot compresses can become completely ineffective or have very unclear effects. Clinical manifestations include pain and swelling, with local formation of lumps or tumor-like appearances. It can also affect the joint mobility around it, and even cause atrophy of limbs and muscles. In terms of treatment, it still relies on early surgical excision, but the prognosis is still not very optimistic.

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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%.

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Osteosarcoma imaging manifestations

The radiological features of osteosarcoma start with an introduction to X-ray imaging. X-rays can show typical new bone formation and bone destruction, which are characteristic features of X-rays. Destruction of bone trabeculae can also be seen on X-rays. Additionally, the density of the tumor tissue increases, leading to a characteristic X-ray known as the Codman's triangle, which occurs when the tumor penetrates the bone and pushes up the periosteum, creating a unique image of Codman's triangle. The second examination includes CT scans and MRI, which are primarily used to determine the nature and extent of the bone tumor, and whether there is infiltration into the surrounding soft tissues. The third radiological examination is a nuclear bone scan, which is primarily important for determining whether the myeloma has metastasized to distant sites.

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Is osteosarcoma serious?

Osteosarcoma is a fairly serious condition. It is a type of malignant bone tumor and is classified as stage II according to the Eric staging system. Regardless of the treatment method used for osteosarcoma, the first issue is that it metastasizes quickly, and the second is that it tends to recur frequently. Therefore, once someone has osteosarcoma, it poses significant challenges, not only being difficult to treat but also involving considerable treatment costs. However, thanks to the efforts of researchers, a new adjuvant chemotherapy has been developed which has increased the five-year survival rate of osteosarcoma from 47% to about 80%, which is quite remarkable. Moreover, with this new adjuvant chemotherapy, patients first undergo chemotherapy, followed by surgery, during which chemotherapy is administered again, not only improving the five-year survival rate but also enhancing the quality of life for patients. Therefore, osteosarcoma is a very serious disease. In the past, amputation was common, followed by distal metastasis, so it didn't take long for metastases to appear in the lungs or brain. Thus, osteosarcoma is an extremely serious disease.

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Does osteosarcoma require amputation?

Do osteosarcomas require amputation? In the past, the likelihood of amputation for treating osteosarcoma was very high. However, currently, the rate of amputation is very low, and the limb-salvage rate is very high. This is due to a new chemotherapy protocol in medical practice, which involves initial chemotherapy followed by surgery, and then continued chemotherapy post-operatively. The limb-salvage rate with this treatment plan can reach about 75% to 80%. Therefore, currently, most osteosarcoma patients do not require amputation. Unlike the past, where amputation rates were very high, today's medical approach is very advanced, generally resulting in a very high rate of limb preservation for osteosarcoma patients.