Osteosarcoma can exhibit which symptoms?

Written by Wang Cheng Lin
Orthopedics
Updated on March 27, 2025
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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 Wang Cheng Lin
Orthopedics
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What is the metastatic pathway of osteosarcoma?

Osteosarcoma commonly spreads in three ways. The first is through hematogenous dissemination, meaning that tumor cells spread throughout the body via the bloodstream, a process known as hematogenous spread. The second method is called implantation metastasis, where tumor cells directly implant in the common sites of osteosarcoma, leading to localized disease. The third type is lymphatic spread, where tumor cells spread to multiple parts of the body through the lymphatic system, causing new tumor growth. These three pathways are the most common routes of metastasis seen clinically in osteosarcoma, with hematogenous spread being the most frequent.

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Written by Li Jie
Orthopedics
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Symptoms of osteosarcoma recurrence

Osteosarcoma is a relatively common type of malignant bone tumor, ranking second in incidence among malignant bone tumors. Typically, upon the development of osteosarcoma, surgery is required to scrape out the tumor focus, followed by limb-sparing or amputation surgery. Additionally, adjuvant radiotherapy and chemotherapy are employed. Generally, the local area may be maintained for a period, but the disease is prone to recurrence. There may be local recurrence at the site of surgery or distant recurrence, meaning tumor cells might seed and lead to tumors in other locations. Symptoms of both local and distant recurrences are similar to those at the initial onset, generally including significant pain, night pain, and rest pain. There will also be distinct X-ray signs of osteosarcoma in the bone. Furthermore, osteosarcoma may metastasize to the lungs, potentially causing symptoms such as cough, bloody sputum, phlegm, and fever—typical signs of intrapulmonary tumors. These are some of the common symptoms associated with the recurrence of osteosarcoma.

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Written by Wang Cheng Lin
Orthopedics
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Do osteosarcomas hurt?

The early symptoms of osteosarcoma include pain, which initially is intermittent. As the condition progresses, this intermittent pain gradually becomes constant, and the intensity of the pain is parallel to the severity of the osteosarcoma, meaning the more severe the osteosarcoma, the more intense the pain. Additionally, you can also feel a lump forming on the affected limb, and this lump is clearly tender to touch. The third symptom is the occurrence of a limp. This limp is due to pain, which prevents the patient from bearing weight and walking for extended periods. Lastly, all osteosarcomas present symptoms such as anemia, pathologic fractures, and a low-grade fever.

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Written by Guan Yu Hua
Orthopedic Surgery
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Can late-stage osteosarcoma be cured?

For osteosarcoma in its late stages, it often metastasizes to other organs, with the majority of cases involving lung metastasis. In such cases, conservative treatment can be applied. However, if surgery is an option, it is the best approach as it can be complemented with postoperative chemotherapy and radiotherapy to extend the patient’s survival time. If there is distant metastasis and the body is in poor condition, unable to withstand surgery, then only conservative treatment and nutritional support are viable, along with the use of painkillers. In late stages, when the patient cannot tolerate surgery, only conservative treatment is available with no other alternatives. Typically, the conditions are divided into three stages. By stage three, there is usually lung metastasis. This stage often involves T which signifies intracompartmental or extracompartmental growth—T2 indicating extracompartmental, typically a marker of an aggressive tumor. Then M represents metastasis, with 0 for none and 1 for presence. So, in cases where distant metastasis occurs, it generally corresponds to stage three, phase B, which involves extracompartmental invasive metastasis. In such cases, even surgery provides poor outcomes. Early detection and treatment are best. If it progresses to later or final stages, treatment is often deemed unnecessary, limited to conservative management, as surgical outcomes are poor, and metastasis may occur elsewhere.

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Written by Wang Cheng Lin
Orthopedics
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The cause of osteosarcoma

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.