What tests are done to diagnose osteosarcoma?

Written by Wang Cheng Lin
Orthopedics
Updated on March 10, 2025
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The most accurate diagnostic method for osteosarcoma is biopsy, where live tissue is extracted and sent for pathological examination. The positive rate of this method can reach over 90%. Besides biopsy, there are several other methods to examine such conditions. For example, X-rays can be taken to observe significant damage to the bone structure. Secondly, CT scans and MRI can be used to determine whether the bone tumor has infiltrated surrounding tissues. MRI can also detect if there are metastases to organs outside the lungs. The third method is radionuclide bone scanning, which primarily aims to check for distant metastases of osteosarcoma.

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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 Peng Li Bo
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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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Written by Na Hong Wei
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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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What are the symptoms of osteosarcoma?

Osteosarcoma is a very common malignant tumor, primarily occurring at the distal femur, proximal tibia, and proximal humerus. Its manifestations mainly include persistent pain at these three locations, which gradually worsens and is accompanied by nighttime pain. Secondly, there is local swelling; the surface of the tumor may feel warmer to the touch and may even exhibit prominent veins, leading to restricted joint movement near the tumor. Thirdly, some patients may exhibit signs of systemic deterioration, such as weight loss, anemia, and fatigue. Fourthly, osteolytic osteosarcomas often erode the bone cortex, eventually weakening the bone and leading to pathological fractures. Thus, the symptoms of osteosarcoma include persistent pain in specific areas accompanied by nighttime pain, local swelling, systemic deterioration, and pathological fractures in many patients.

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Is osteosarcoma treatable?

Osteosarcoma is not about whether it can be treated, but it must be treated. Moreover, the earlier the treatment, the higher the five-year survival rate. Currently, the treatment for osteosarcoma still primarily involves comprehensive therapy centered around surgery. With the advent of neoadjuvant chemotherapy, the five-year survival rate for osteosarcoma has significantly increased. Specifically, once osteosarcoma is diagnosed, extensive chemotherapy is administered before surgery. After chemotherapy, depending on the extent of tumor invasion, either radical segmental resection, limb-sparing surgery, or amputation is considered. Postoperative treatment also requires continued high-dose chemotherapy. In fact, if osteosarcoma is not treated, it metastasizes very quickly, primarily to the lungs. However, if the treatment is very early, timely, and correct, the current five-year survival rate has reached about 80%. Therefore, osteosarcoma can be treated, and the earlier the treatment, the better the outcomes.