The common sites of osteosarcoma

Written by Wang Cheng Lin
Orthopedics
Updated on December 27, 2024
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Osteosarcoma commonly occurs in the long tubular bones of the limbs, such as the femur, tibia, and humerus, especially near the joints of these long bones where the incidence is highest. In children, the distal femur and proximal tibia account for about three-quarters of all bone tumors. Osteosarcoma can also occur in the proximal humerus, the spine, and the ribs, although it is less common in these locations. The most frequent sites remain the long tubular bones in the limbs.

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Written by Guan Yu Hua
Orthopedic Surgery
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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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Written by Wang Cheng Lin
Orthopedics
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Do benign osteosarcomas use chemotherapy?

First of all, all osteosarcomas are malignant; osteosarcoma is a type of malignant tumor with no benign variant. Regarding the treatment of osteosarcoma, the first step is chemotherapy. After confirming the diagnosis through pathological examination and confirming it is osteosarcoma, The first step is chemotherapy, which can stabilize the tumor cells; Then, the main tissue is surgically removed, as well as the surrounding infiltrated soft tissue; The third step is to use chemotherapy again to eliminate the residual cancer cells. This treatment protocol of chemotherapy-surgery-chemotherapy is currently the most common and advanced method in the country. It can significantly improve the patient's survival rate, reduce the risk of amputation, and can also prevent the recurrence of osteosarcoma.

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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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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 Guan Yu Hua
Orthopedic Surgery
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How big do osteosarcomas generally grow?

The size of osteosarcoma is generally difficult to measure. By undergoing radiographic examination, Codman's triangle and bone destruction can be observed in the patient's images, which can be diagnosed as osteosarcoma. Further biopsy is then required. Osteosarcoma typically presents as a mass approximately the size of a fist, and early stages may involve malignant pulmonary metastasis. By conducting a pulmonary CT scan, lesions and metastatic foci can be discovered, primarily indicating bone destruction and the presence of Codman's triangle. Such destruction can deform the normal bone structure, and abnormal masses may be palpable during physical examinations, presenting in irregular shapes. This condition is commonly seen and cannot be evaluated merely by the size of the osteosarcoma. Early stages may involve lung metastasis, progressing to advanced stages where the prognosis is poor and survival rates significantly decrease. Therefore, this disease generally requires early diagnosis and treatment.