Causes of Osteosarcoma Formation

Written by Wang Cheng Lin

Orthopedics

Updated on January 24, 2025

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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 Guan Jing Tao

Orthopedics

48sec

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Can osteosarcoma be seen on an X-ray?

Osteosarcoma can be detected through characteristic changes in X-ray imaging, such as the Codman's triangle, which usually occurs around the joints at the metaphyseal ends of the long tubular bones in the limbs. This leads to the destruction of the trabeculae and increased density of the tumor tissue, which can break through the cortical bone. The tumor can lift the periosteum to form the characteristic Codman's triangle. Therefore, orthopedic doctors can preliminarily diagnose it as a bone tumor or osteosarcoma based on the appearance in this X-ray. Additionally, diagnosis should be correlated with clinical symptoms such as the presence of a noticeable mass, pain, tenderness in the localized area, and general symptoms of cachexia, such as weight loss, anemia, fever, and malaise.

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Written by Guan Yu Hua

Orthopedic Surgery

1min 36sec

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How should osteosarcoma be treated?

Osteosarcoma is a malignant tumor that devours bone, commonly occurring in adolescents and young adults, typically at the proximal end of the tibia or the distal end of the femur, and at the proximal end of the humerus in the upper limbs, which is the metaphysis. The main clinical symptoms are pain, which becomes more pronounced at night, and there is generally a mass at the site, with limited movement. The local skin temperature may increase, and some may exhibit distended veins. Patients with malignant tumors generally gradually lose weight, eventually developing cachexia and even pathological fractures. Osteosarcoma is asymptomatic in its early stages, and once detected, it is usually in the middle to late stages. Radiographic examinations are necessary for diagnosis, typically showing specific changes such as Codman’s triangle or a sunburst pattern, which are characteristic of osteosarcoma. Surgery is necessary at times, to remove and examine the pathology. Common surgical approaches include resection with inactivation and reimplantation, or the insertion of a prosthesis for limb-sparing procedures, while another option is amputation, followed by extensive chemotherapy. With the rapid advancements in chemotherapy in recent years, the survival rate for osteosarcoma has generally increased significantly, typically about 50% over five years. However, early-stage pulmonary metastasis occurs very frequently with osteosarcoma, necessitating early diagnosis and treatment. The primary treatment is surgical, complemented by postoperative chemotherapy.

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Written by Na Hong Wei

Orthopedics

58sec

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Osteosarcoma mainly metastasizes through

The main metastatic pathways of osteosarcoma are generally divided into three types. The first is hematogenous spread, which refers to the dispersal of tumor cells throughout the body via the bloodstream, typically settling in areas with slower blood flow which facilitates the deposition of these cells leading to local changes. The second is direct implantation, which involves tumor cells directly establishing themselves in the vicinity of the tumor's common sites, eventually leading to local metastasis. The third type is lymphatic spread, where tumor cells migrate through the lymphatic system, spreading along lymphatic vessels or pathways. Therefore, the main metastatic pathways of osteosarcoma are these three types. The primary sites of metastasis for osteosarcoma are mainly the lungs, but metastases can also occur in the brain or through other mechanisms.

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Written by Na Hong Wei

Orthopedics

1min 17sec

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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

48sec

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How to prevent osteosarcoma

From the perspective of osteosarcoma itself, prevention should involve active exercise, a healthy lifestyle, and a regular schedule. All of these can play a preventive role. However, as of now, there is no clear cause of what triggers osteosarcoma, and it is still unknown. For patients with osteosarcoma, we need to achieve early diagnosis and early treatment. Since many osteosarcomas occur in adolescents, if your child complains of bone pain and feels lumps, and more severely, experiences joint functional impairment, parents must be vigilant. It is advised for the patient to go to a hospital and have an imaging test done to confirm if it is caused by osteosarcoma. Therefore, early diagnosis and early treatment are best.