Osteosarcoma

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Written by Wang Cheng Lin
Orthopedics
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Can osteosarcoma be detected by ultrasound?

Osteosarcomas are generally difficult to diagnose through ultrasound. The diagnosis of osteosarcoma mainly relies on the following methods. The first method is X-rays. X-rays can reveal a typical Codman's triangle appearing in the bone. The second method involves using CT and MRI to detect the extent of the tumor and to see if there is extensive infiltration around it. The third method is nuclear bone scanning. The main significance of nuclear bone scanning is to detect bone tumors early and to distinguish whether there has been any metastasis in the later stages. The fourth method is the gold standard, which is to perform a biopsy. However, this test is invasive, requiring the cutting of tissue from the osteosarcoma for pathological examination. Of course, this method provides the highest accuracy and positive rate.

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Written by Li Xin
Pediatric Orthopedics
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osteosarcoma X-ray presentation

The variations in the X-ray appearance of osteosarcoma are quite large, but the basic characteristics are a mix of osteolytic destruction and pure bony changes. In most cases, besides the mixed changes, there is also destruction of the bone cortex and invasion of soft tissues, with visible periosteal reaction. The epiphysis has a certain blocking effect on the tumor, hence it rarely crosses the epiphyseal line. On the X-ray, changes indicative of skip metastasis can be seen, along with typical Codman's triangle or sunburst patterns. Beneath the periosteum, there are fine, needle-like sunburst radiating changes, which are fairly typical radiographic changes of osteosarcoma and are generally used to diagnose the condition.

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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 is osteosarcoma?

Osteosarcoma is a type of malignant tumor that occurs in the bones, generally classified as stage IIb. Common sites for osteosarcoma include the distal part of the bone, the proximal tibia, and the proximal humerus. It most commonly affects adolescents. Clinically, it primarily presents as persistent pain, including nighttime pain. Swelling and limited joint function typically occur around the common sites. Additionally, there are general symptoms associated with cachexia, such as malnutrition, anemia, mild or high fever, or weight loss. Fourthly, it is very prone to causing pathological fractures. Many osteosarcoma patients seek medical attention due to these fractures. Thus, osteosarcoma is a serious malignancy in the bones with a generally poor prognosis. Diagnosis and treatment of osteosarcoma are crucial; upon confirmation, timely treatment is necessary. The primary treatment approach is a combination therapy centered around surgery, typically involving preoperative chemotherapy, followed by surgical treatment and postoperative chemotherapy. Currently, the five-year survival rate for osteosarcoma has significantly improved, reaching approximately 70% to over 80%.

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Written by Na Hong Wei
Orthopedics
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Osteosarcoma is a type of cancer.

Osteosarcoma is a relatively common type of malignant bone tumor in clinical practice. It mainly occurs near the ends of the humerus, including the area around the head of the humerus, and at the distal end of the femur, near the femoral condyles, as well as the proximal tibia, close to the tibial plateau. These are its common sites. It predominantly affects teenagers, generally those under 18 years of age. The main symptoms include: firstly, persistent and worsening pain that gradually intensifies and does not alleviate, with the notable characteristic being that the pain is more severe at night than during the day; secondly, the appearance of spindle-shaped tumors around the joints, particularly at the three aforementioned common sites, often accompanied by redness, warmth, pain in the superficial skin, and even prominent superficial veins; thirdly, osteosarcoma is a type of malignant tumor, classified as grade 2B among malignant tumors. Its main feature, apart from local symptoms, is its propensity for metastasis, with the lungs being the most likely site of metastasis.

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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.

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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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How long is the latent period of osteosarcoma?

In clinical practice, there is no such thing as a latency period for malignant bone tumors, because these tumors progress very quickly. So, if you experience symptoms such as swelling and pain in the affected limb, if you can feel a mass, and if the pain severely impacts your daily life, you should promptly go to a hospital to get an imaging test done to determine whether a bone tumor is present. Only through imaging and accurate diagnosis can early diagnosis and treatment be achieved, which is the best treatment approach for osteosarcoma. Therefore, in clinical practice, there is no concept of a latency period for malignant bone tumors.

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Written by Dai Ru
Orthopedics
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Is osteosarcoma bone cancer?

Osteosarcoma is a type of malignant tumor that originates from the bone. Bone cancer is a common term used by people to refer to bone tumors. The terms cancer and sarcoma are different mainly because of their different origins. Cancer primarily originates from epithelial tissue, such as liver cancer, lung cancer, etc. Because bones consist of mesenchymal cells, malignant tumors of the bone are called osteosarcomas, not bone cancer. Osteosarcomas commonly occur in children and adolescents and are a highly malignant type of bone tumor that require prompt treatment once diagnosed.

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Written by Wang Cheng Lin
Orthopedics
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What are the symptoms of osteosarcoma?

Symptoms of Osteosarcoma: The first is pain at the site of occurrence. This pain may be intermittent and not very pronounced in the early stages. As the condition progresses, the severity of the pain gradually increases, transitioning from intermittent to persistent pain; The second is the formation of a lump. You can feel a lump on the limb with your hand, and this lump is clearly tender to the touch; The third is limping, which is mainly caused by the pain in the limb; The fourth is the most common systemic symptoms. Patients with this malignant tumor will exhibit fever, weight loss, anemia, and pathological fractures. These are the main symptoms of osteosarcoma currently observed in clinical settings.