The cause of osteosarcoma

Written by Wang Cheng Lin
Orthopedics
Updated on April 22, 2025
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At present, the causes of osteosarcoma are not yet clear, but it may be related to genetics, exposure to radioactive substances, and viral infections. It can also be secondary to other deformative osteitis and fibrous dysplasia of bone. Furthermore, some cases can also develop from other benign tumors, gradually degenerating into malignant tumors. Osteosarcoma commonly affects the long bones, mostly located at the metaphyseal ends, with fewer cases in the middle of the diaphysis. The tumor develops very rapidly, generally spreading gradually towards the ends of the bone, destroying the bone tissue, causing the tumor mass to quickly reach under the periosteum, and invading the neighboring muscle tissue outwardly.

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Written by Wang Cheng Lin
Orthopedics
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Do benign osteosarcomas use chemotherapy?

First of all, all osteosarcomas are malignant; osteosarcoma is a type of malignant tumor with no benign variant. Regarding the treatment of osteosarcoma, the first step is chemotherapy. After confirming the diagnosis through pathological examination and confirming it is osteosarcoma, The first step is chemotherapy, which can stabilize the tumor cells; Then, the main tissue is surgically removed, as well as the surrounding infiltrated soft tissue; The third step is to use chemotherapy again to eliminate the residual cancer cells. This treatment protocol of chemotherapy-surgery-chemotherapy is currently the most common and advanced method in the country. It can significantly improve the patient's survival rate, reduce the risk of amputation, and can also prevent the recurrence of osteosarcoma.

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Written by Na Hong Wei
Orthopedics
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How is osteosarcoma diagnosed?

Currently, the diagnosis of osteosarcoma in clinical settings primarily relies on a combination of clinical symptoms, imaging studies, and pathological findings. Clinically, osteosarcomas commonly occur in the distal femur, proximal tibia, and lower end of the humerus, manifesting as localized persistent pain, nocturnal pain, and swelling, often accompanied by superficial venous engorgement and increased skin temperature. Systemic symptoms of cachexia may appear, and even pathological fractures. Imaging is indispensable, revealing osteoblastic, osteolytic, or mixed osteolytic lesions, usually with a pronounced periosteal reaction, Codman's triangle (a common sign of malignancy), or sunburst patterns. Magnetic resonance imaging (MRI) is very important for diagnosing bone tumors as it can indicate the tumor's boundaries and the extent of erosion. Additionally, PET-CT and radioactive isotope scanning are considered crucial for tumor diagnosis. Pathological examination is currently regarded as the gold standard for diagnosing osteosarcoma. This involves a biopsy, usually taking a small part of the tumor for examination from a molecular biology perspective. However, when performing a biopsy, it is important to note two things: first, it is preferable to take the biopsy intraoperatively; second, if there is no plan for systematic treatment of osteosarcoma, it is best not to proceed with a biopsy to avoid potentially accelerating the spread or even hastening metastasis. Therefore, the diagnosis of osteosarcoma must be approached with caution, requiring a combination of clinical symptoms, necessary auxiliary examinations, and pathological analysis.

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Written by Wang Cheng Lin
Orthopedics
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Osteosarcoma can exhibit which symptoms?

The symptoms of osteosarcoma, first of all, include pain. The severity of the tumor varies, and so does the accompanying pain. If the tumor significantly damages the bone, causing stimulation to the nerve endings of the periosteum, it will lead to increased pain; Secondly, there is a lump. A lump can be felt on the limb, but this lump also comes with significant tenderness. The growth rate of this lump depends on the condition; Third, there is limping. This limping is also due to limb pain, which causes progressive limping symptoms when walking, and prolonged limping can also lead to joint stiffness and muscle atrophy; Fourth, there are systemic symptoms. Any patient with malignant tumors will experience weight loss, anemia, and multi-organ failure, and may even suffer from pathological fractures.

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Written by Guan Jing Tao
Orthopedics
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Can patients with osteosarcoma have children?

Whether osteosarcoma patients can have children requires comprehensive consideration. One factor is that the patient's age should not be too old. Additionally, one must consider the individual's response after surgery and subsequent performance after treatment. Besides, regular check-ups should be conducted, and attempts to conceive can be made if there is no obvious abnormality or other pathological changes in the body. However, it is essential to conduct regular follow-ups and be mentally prepared. The possibility of various problems during pregnancy should not be ruled out, such as a decrease in immune response, which could trigger a recurrence of the bone tumor or other conditions, potentially leading to health issues for the child or the mother. Thus, a comprehensive and thorough evaluation is necessary.

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Written by Wang Cheng Lin
Orthopedics
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What tests are done to diagnose osteosarcoma?

The most accurate diagnostic method for osteosarcoma is biopsy, where live tissue is extracted and sent for pathological examination. The positive rate of this method can reach over 90%. Besides biopsy, there are several other methods to examine such conditions. For example, X-rays can be taken to observe significant damage to the bone structure. Secondly, CT scans and MRI can be used to determine whether the bone tumor has infiltrated surrounding tissues. MRI can also detect if there are metastases to organs outside the lungs. The third method is radionuclide bone scanning, which primarily aims to check for distant metastases of osteosarcoma.