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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During the treatment of osteosarcoma

Osteosarcoma is a highly malignant tumor of the bone, primarily presenting with pain, elevated skin ridges, and bulging veins. Radiological examination often reveals bone abnormalities, such as Codman's triangle and periosteal reactions due to sun exposure. If there is no metastasis in the early stages, limb amputation surgery can be performed, as well as limb-sparing surgeries involving devitalization and reimplantation or prosthetic implantation. Post-operative treatment involves high-dose chemotherapy, which can inhibit the growth of the bone tumor and extend the patient's survival time. There is a high probability of lung metastasis occurring in the early stages of the disease. If metastasis occurs, the survival time may be significantly reduced. Early diagnosis of this disease is crucial, and it must be treated with chemotherapy as early as possible. With the rapid development of chemotherapy, the five-year survival rate for osteosarcoma can increase to over 50%. Thus, early detection, early treatment, early surgery, followed by chemotherapy and radiotherapy are essential to prolong the patient's survival time.

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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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The main metastasis pathways of osteosarcoma

Osteosarcoma is a primary tumor of bone tissue. The tumor can metastasize through the bloodstream, lymphatic system, or nearby tissue. The most common site of metastasis for osteosarcoma clinically is to the lungs. Therefore, it is often recommended that patients undergo chest X-rays or even chest CT scans to detect any metastasis to the lungs.

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Symptoms of osteosarcoma

The common symptoms of osteosarcoma include, first, pain which is often persistent, typically occurring at the distal femur, proximal tibia, and proximal humerus. The characteristic of this pain is that it worsens at night, more severe than during the day. Second, there is local swelling usually near joints, particularly at the three aforementioned common sites. The skin over the swelling often becomes warm and may even show redness, and some patients may have dilated surface veins. The swelling can frequently cause dysfunction of nearby joints, or restricted function. Third, systemic symptoms primarily include a persistent wasting syndrome, known as cachexia. Fourth, osteosarcomas can weaken the bone's load-bearing capacity and strength following cortical bone involvement, eventually leading to pathological fractures. Therefore, the main symptoms of osteosarcoma are localized pain, local swellings, systemic manifestations of cachexia, or pathological fractures.

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Osteosarcoma common onset age

Osteosarcoma most commonly occurs in adolescents under the age of 20, or in children, and is a type of malignant tumor. It is the most common malignant bone tumor in children, accounting for about 5% of all malignant tumors in children, making this age group highly susceptible to osteosarcoma. The formation of osteosarcoma is mainly due to external factors such as viral infections and genetic mutations that lead to cell mutations. Osteosarcoma is a typical malignant tumor that destroys bone and surrounding soft tissue, leading to pathological fractures. It can also form distant metastases, thus posing a significant threat.