What are the symptoms of osteosarcoma?

Written by Na Hong Wei
Orthopedics
Updated on September 19, 2024
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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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Is a fracture in osteosarcoma very dangerous?

Osteosarcoma is a malignant tumor of the bone, commonly found in adolescents and young adults, primarily occurring near the proximal tibia, distal femur, and proximal humerus, mostly at the metaphyseal ends. The tumor itself can lead to bone destruction and periosteal reactions. Pathological fractures may occur, which are frequently observed clinically. If a fracture occurs, radiographic examination can generally detect it, often showing a Codman's triangle or sunburst pattern. Early detection and treatment are crucial. Once a pathological fracture is observed, it typically indicates a middle to late stage of the disease, with a particularly high likelihood of lung metastasis. The situation with just a pathological fracture is quite severe, and unlike other fractures that might be managed with steel plates or intramedullary pins, treatment here is conservative, possibly requiring amputation, though limb-sparing approaches may also be necessary. Detecting the condition early, before distant metastasis, and combining treatment with radiotherapy or chemotherapy, can result in a five-year survival rate above 50%. The threat posed by pathological fractures alone is significant, and amputation may be necessary, with chemotherapy likely required post-surgery.

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Why is there a cough in osteosarcoma?

Osteosarcoma ranks second in the incidence of malignant tumors in the whole body's bones; its incidence is relatively high. It generally occurs in the long tubular bones, shafts, or epiphyseal areas of the limbs. Since the most common organ metastasis of osteosarcoma is to the lungs, if a patient with osteosarcoma develops a cough, it should be taken seriously, and it's recommended that the patient undergo a targeted examination such as a chest X-ray or a CT scan of the lungs to check for lung metastasis and any lesions on the lungs. However, there is no need to panic prematurely, as osteosarcoma patients might cough due to upper respiratory infections or lung infections, which doesn't necessarily indicate lung metastasis. Therefore, once a patient with osteosarcoma develops a cough, a targeted examination should suffice.

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Symptoms of osteosarcoma metastasis to the lungs

Osteosarcoma is a malignant tumor of the bone, most commonly found in adolescents and young adults. The most frequent sites are the distal femur, the proximal tibia, or the proximal humerus. Early-stage patients often experience lung metastases, which are quite common. Initially, there are no symptoms; however, as the disease progresses, symptoms such as lumps, significant pain especially at night, increased local skin temperature, dilated veins, and weight loss may appear. At this stage, radiographic examinations are imperative to identify the tumor presence, indicated by findings such as a Codman triangle or sunray appearance, which are suggestive of osteosarcoma, though confirmation through pathology is essential. Furthermore, comprehensive body scans are necessary to check for metastases. Early-stage lung metastases might not show symptoms, but as the disease advances, symptoms like coughing, coughing up blood, and pleural effusion, possibly bloody, may develop. Severe cases can lead to respiratory difficulties and cachexia. Early detection and treatment, combined with postoperative chemotherapy, can lead to a five-year survival rate of over 50%. However, the disease is often diagnosed in its intermediate to late stages due to the absence of early symptoms, making it challenging to detect.

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How long can osteosarcoma last?

Osteosarcoma, also known as osteogenic sarcoma, commonly occurs in adolescents, especially in children and teenagers under the age of 20. It is one of the most malignant tumors among bone tumors, with most patients dying within six months to a year. However, early detection and treatment can potentially extend survival. The survival period of osteosarcoma depends on the location of the tumor; the closer to the distal extremities, the longer the survival period after treatment; the closer to the trunk, even with treatment, the survival period is not very long.

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Osteosarcoma imaging manifestations

The radiological features of osteosarcoma start with an introduction to X-ray imaging. X-rays can show typical new bone formation and bone destruction, which are characteristic features of X-rays. Destruction of bone trabeculae can also be seen on X-rays. Additionally, the density of the tumor tissue increases, leading to a characteristic X-ray known as the Codman's triangle, which occurs when the tumor penetrates the bone and pushes up the periosteum, creating a unique image of Codman's triangle. The second examination includes CT scans and MRI, which are primarily used to determine the nature and extent of the bone tumor, and whether there is infiltration into the surrounding soft tissues. The third radiological examination is a nuclear bone scan, which is primarily important for determining whether the myeloma has metastasized to distant sites.