How big do osteosarcomas generally grow?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on January 19, 2025
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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.

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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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Causes of Osteosarcoma Formation

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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Written by Na Hong Wei
Orthopedics
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What are the symptoms of osteosarcoma?

The main symptom of osteosarcoma is localized pain, primarily at the distal end of the femur, the proximal end of the tibia, and the proximal end of the humerus. This pain tends to worsen continuously, with nighttime pain often more severe than during the day, which is a significant characteristic of osteosarcoma. The second symptom is the presence of a local mass, which is often spindle-shaped and generally located near a joint. This mass often leads to limited joint mobility, and the skin over the mass typically has a high temperature. Sometimes, it may also be accompanied by visible swelling of superficial veins. The third symptom involves systemic cachexia, which includes unexplained weight loss, generalized weakness, and even an anemic condition. The fourth point pertains to osteolytic osteosarcoma, which often leads to bone destruction, reduced bone strength, and consequently, even minor external forces can cause fractures. These are called pathological fractures. Thus, the symptoms of osteosarcoma generally include these four points.

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Written by Fang Da Zheng
Orthopedics
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Are osteosarcomas sensitive to radiotherapy and chemotherapy?

Osteosarcoma is generally insensitive to radiotherapy, hence radiation therapy is not used for such diseases in clinical settings. Similarly, these diseases have a moderate sensitivity to chemotherapy, necessitating the use of relatively high doses of chemotherapy during treatment. The main mechanism of chemotherapy involves using a series of cytotoxic drugs to inhibit tumor growth. Although high-dose chemotherapy can effectively kill tumor cells, it can also damage some of the patient's normal cells, leading to severe reactions. If radical surgery is viable for these patients, then curative surgery is the preferred method of treatment.

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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.