What is Osteosarcoma?

Osteosarcoma, also known as osteosarcoma, is a malignant bone tumor that most commonly occurs in adolescents or children under 20 years of age. It is most common in pediatric bone malignancies, about 5% of pediatric tumors.

Basic Information

Also known as: Osteosarcoma
English name: osteosarcoma
Visiting department: orthopedics
Multiple groups: Youth or children under 20

Common locations: bone
Common symptoms: Pain, lump, lameness, fever, discomfort, weight loss, anemia, etc.
Contagious: no

Causes of osteosarcoma

Osteosarcoma is the most common type of bone malignant tumors. It develops from mesenchymal cell lines. The rapid growth of tumors is caused by the formation of tumor bone-like tissue and bone tissue directly or indirectly through the cartilage stage of the tumor. The mutation of cells in the lower extremity weight-bearing bone under the influence of external factors (such as viruses) may be related to the formation of osteosarcoma.

The typical osteosarcoma originates from the bone, and another completely different type is the osteosarcoma juxtaposed with the cortex of bone, which originates from the periosteum and nearby connective tissue. The latter is rare and has a slightly better prognosis.

Clinical manifestations of osteosarcoma

The prominent symptom of osteosarcoma is pain in the tumor site, caused by tumor tissue infiltration and dissolution of the bone cortex.

Pain

Different degrees of pain in the tumor site are very common and obvious symptoms of osteosarcoma, caused by swollen tumor tissue destroying the bone cortex and stimulating periosteal nerve endings. The pain can develop from early intermittent to persistent after several weeks, and the degree of pain can be increased. Painless claudication may occur in the lower extremity.

2. Lump

With the development of the disease, swelling may occur locally, touching the mass in the painful part of the limb, with obvious tenderness. For those who grow rapidly, they can be found on the appearance. The skin temperature of the mass is increased and superficial veins are exposed. The surface of the mass and nearby soft tissues may have tenderness to varying degrees. Due to the degree of ossification, the hardness of the mass varies. The enlarged mass causes limited joint movement and muscle atrophy.

3. limp

Pain-avoiding lameness caused by limb pain is exacerbated with the progress of the disease, and the elderly who have suffered for a long time may have limited joint movements and muscle atrophy.

4. General condition

When the diagnosis is clear, the general condition is generally poor, manifesting as fever, discomfort, weight loss, anemia, and failure. In some cases, tumors grow rapidly, and lung metastases occur early, resulting in deterioration of the general condition. Pathological fractures at the tumor site make the symptoms more pronounced.

Osteosarcoma examination

In the case of osteoblastic osteosarcoma, an increase in bone-derived alkaline phosphatase in the blood can be detected early, which is related to the osteogenesis of the tumor. Pathological diagnosis is the basis of treatment. When the diagnosis of osteosarcoma is taken into consideration, biopsy and the confirmation of pathological examination as soon as possible are of great significance for clear diagnosis and treatment.

1. X-ray film

The typical X-ray of osteosarcoma shows that the bone tissue has the characteristics of both new bone formation and bone destruction. Most tumors are located at the metaphysis of long tubular bones, with unclear edges, trabecular bone destruction, and increased tumor tissue density. After penetrating the cortical bone, the tumor lifts up the periosteum, resulting in characteristic X-ray signs of the disease. Deman sleeve triangle (Codman-triangle). This phenomenon is seen in some patients with osteomyelitis and Ewing's sarcoma, and it is very typical in osteosarcoma. Late stage can see the shadow of tumor infiltrating soft tissue, pathological fractures can be seen in some cases.

2.CT scan and MRI examination

It is an effective method to judge the nature and scope of bone tumors and the presence or absence of surrounding soft tissue infiltration. It can detect metastatic lesions of the lungs and other organs at an early stage. It is a routine item in clinical examination of

3. Nuclide bone scan

It is a common method for early detection and later identification of metastatic lesions.

Osteosarcoma diagnosis

Diagnosis can be made based on medical history, clinical manifestations, and auxiliary examinations. Osteosarcoma should be distinguished from osteomyelitis and Ewing sarcoma.

Osteosarcoma complications

Osteosarcoma can cause painful lameness, limited joint mobility, and muscle atrophy.

Osteosarcoma treatment

Osteosarcoma is still a disease with a high mortality rate in children and adolescents, but early detection and timely treatment have greatly improved the survival rate of the disease.

After the diagnosis of osteosarcoma by pathology, the early chemical or radiotherapy is started. Removal of tumor tissue is an important step in the treatment of osteosarcoma. With the improvement of tumor surgery technology and the development of built-in research, limb preservation therapy has shown good prospects for treatment. Consolidated chemical or radiotherapy after tumor tissue resection is very important to control tumor metastasis and improve survival rate.

Radical surgery should be performed to treat osteosarcoma. Those who have the conditions can do extensive local resection while retaining limbs. In addition, a biopsy should be performed before amputation.

Immunotherapy involves the intravenous infusion of lymphocytes or the use of interferons and transfer factors, but the efficacy is not yet certain.

Osteosarcoma prognosis

The closer the tumor site is to the trunk, the higher the mortality rate. As for the relationship between the type of tumor and the degree of vascular abundance and prognosis, it is difficult to judge. The patient's immune response should also be addressed. Advanced tumors undergo amputation surgery, and some can survive for a long time, no recurrence after radiation treatment, and lung metastases can dissipate. This may be related to the immune response.

The key factors affecting prognosis are early diagnosis, whether the tumor is completely removed, chemotherapy and radiotherapy before and after surgery. In addition, it is also related to the tissue type and size of tumor cells, changes in serum alkaline phosphatase before and after surgery, and whether local lymph nodes are involved.