What is osteosarcoma?

Written by Na Hong Wei
Orthopedics
Updated on September 22, 2024
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Firstly, osteosarcoma is a common type of malignant tumor, characterized by a mechanism that produces bone-like tissue. It has multiple subtypes and can also develop into a secondary osteosarcoma. Secondly, it commonly occurs in adolescents. Thirdly, it typically affects the proximal femur, distal tibia, and proximal humerus. Fourthly, common osteosarcomas are generally spindle-shaped, often located near joints. The surface may have elevated skin temperature and sometimes superficial vein distension is apparent. It often involves the entire bone, including the periosteum, cortical bone, and bone cavity. Generally, the tumor appears as a very fine greyish-white or brownish-red fish-flesh-like change. Osteosarcoma is a malignant tumor and is particularly prone to lung metastasis. According to tumor staging, it is at least stage IIB, indicating that it should be detected, diagnosed, and treated early. The earlier the treatment, the better the outcome and the higher the five-year survival rate.

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Written by Na Hong Wei
Orthopedics
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Is osteosarcoma serious?

Osteosarcoma is a fairly serious condition. It is a type of malignant bone tumor and is classified as stage II according to the Eric staging system. Regardless of the treatment method used for osteosarcoma, the first issue is that it metastasizes quickly, and the second is that it tends to recur frequently. Therefore, once someone has osteosarcoma, it poses significant challenges, not only being difficult to treat but also involving considerable treatment costs. However, thanks to the efforts of researchers, a new adjuvant chemotherapy has been developed which has increased the five-year survival rate of osteosarcoma from 47% to about 80%, which is quite remarkable. Moreover, with this new adjuvant chemotherapy, patients first undergo chemotherapy, followed by surgery, during which chemotherapy is administered again, not only improving the five-year survival rate but also enhancing the quality of life for patients. Therefore, osteosarcoma is a very serious disease. In the past, amputation was common, followed by distal metastasis, so it didn't take long for metastases to appear in the lungs or brain. Thus, osteosarcoma is an extremely serious disease.

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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 Na Hong Wei
Orthopedics
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Can osteosarcoma occur on the knee?

Can osteosarcomas grow on the knee? In fact, the locations where osteosarcomas commonly appear are indeed near the knee. There are mainly three common sites: the most prevalent is the distal end of the femur, the lower part of the thigh bone. The second most common site is the proximal end of the tibia. The third is the proximal end of the humerus. Therefore, osteosarcomas usually do grow near the knee. What are the symptoms of an osteosarcoma? The symptoms of osteosarcoma include, first, localized pain, which is a constant pain that persists, worsens, and does not alleviate, often causing night pain, and many patients do not feel pain during the day, only at night. The second symptom is a localized lump, generally spindle-shaped, with an increased skin temperature over the surface, and even distended veins due to the tumor restricting nearby joint movement. The third symptom is the appearance of cachexia or wasting syndrome throughout the body. The fourth point is that the growth of the osteosarcoma leads to erosion of the bone and eventually pathologic fractures. Thus, the likelihood of osteosarcomas appearing near the knee is very high, and many patients typically come to the hospital because of painful lumps near the knee, and then, after examination, the diagnosis is confirmed.

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Written by Na Hong Wei
Orthopedics
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Is there a cure for osteosarcoma?

Osteosarcoma is treatable, but it requires proper medical treatment. Currently, adjuvant chemotherapy significantly improves the five-year survival rate for osteosarcoma. The main treatment approach is still surgery as part of a comprehensive therapy. Specifically, the first step involves adequate preoperative chemotherapy, generally no fewer than six sessions over about eight weeks, or approximately two months. After this, patients often experience reduced pain, weight gain, improved positioning of the tumor, and a decrease in tumor size. Depending on the specific situation, a decision is made on the type of surgery to be performed—whether to amputate, preserve the limb, install a prosthetic, or use artificial bone as a replacement. Postoperative chemotherapy is usually also required to help ensure that the tumor does not recur and to increase the five-year or ten-year survival rate. Therefore, the current five-year survival rate for osteosarcoma has increased from the previous 40%-50% to about 80%. So, as long as one chooses the right hospital and the right treatment plan, and maintains confidence, osteosarcoma is usually treatable.

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Written by Guan Yu Hua
Orthopedic Surgery
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Osteosarcoma Causes

Osteosarcoma is the most common malignant tumor of the bone and typically presents without symptoms in its early stages. The cause of osteosarcoma is unknown, and it often goes undetected until it has reached a moderate or advanced stage. It commonly develops at the distal end of the femur near the knee joint, at the proximal end of the tibia, or at the proximal end of the humerus, primarily at the end of the growth plate. The pain associated with osteosarcoma is usually persistent, especially severe at night, and can lead to symptoms such as anemia or general wasting. The tumor's surface may be warm to the touch, with prominent veins visible, and radiographic imaging might show a Codman's triangle, indicative of sunlight-like radiation patterns, as well as bone destruction and clear periosteal reaction. Surgical treatment is typically pursued, with amputation being the most common procedure, though limb-sparing surgeries are possible if the tumor is detected early enough. Some cases metastasize, most commonly to the lungs, requiring continued high-dose chemotherapy post-surgery to prolong survival. Generally, the five-year survival rate for osteosarcoma can exceed 50% with early diagnosis and treatment. The chances of survival heavily depend on the individual’s constitution, the timing of tumor detection, and the surgical intervention. The exact causes of osteosarcoma are unclear, and the potential for metastasis complicates treatment. Therefore, early surgical intervention is crucial for improving survival rates and enabling patients to maintain a normal life and work activities.