How big do osteosarcomas generally grow?

Written by Guan Yu Hua
Orthopedic Surgery
Updated on January 19, 2025
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The size of osteosarcoma is generally difficult to measure. By undergoing radiographic examination, Codman's triangle and bone destruction can be observed in the patient's images, which can be diagnosed as osteosarcoma. Further biopsy is then required. Osteosarcoma typically presents as a mass approximately the size of a fist, and early stages may involve malignant pulmonary metastasis. By conducting a pulmonary CT scan, lesions and metastatic foci can be discovered, primarily indicating bone destruction and the presence of Codman's triangle. Such destruction can deform the normal bone structure, and abnormal masses may be palpable during physical examinations, presenting in irregular shapes. This condition is commonly seen and cannot be evaluated merely by the size of the osteosarcoma. Early stages may involve lung metastasis, progressing to advanced stages where the prognosis is poor and survival rates significantly decrease. Therefore, this disease generally requires early diagnosis and treatment.

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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 Yu Hua
Orthopedic Surgery
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Can osteosarcoma be treated with moxibustion?

Osteosarcoma is a malignant tumor of the bone, and the treatment effect of moxibustion is not very good. This disease develops quite rapidly, mostly occurring at the proximal end of the tibia, the distal end of the femur, the proximal end of the humerus, among others, typically at the metaphyseal ends. Clinically, the main symptoms include persistent pain, which becomes more pronounced at night, along with local swelling, restricted movement, increased local surface skin temperature, some may show prominent veins, and patients often appear emaciated, severely looking cachectic as the disease progresses with noticeable symptoms. Radiographic examination can reveal Codman's triangle or sunburst patterns. Early detection necessitates early treatment, including surgery such as inactivation reimplantation or prosthesis implantation to sustain operation. Additionally, amputation followed by extensive chemotherapy can effectively improve the patient’s survival time. Osteosarcoma has a high chance of early pulmonary metastasis, requiring systematic treatment at a hospital. Solely using moxibustion is not very effective and has limited usefulness, but it could still be worth a try if there are no better options available.

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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 Na Hong Wei
Orthopedics
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Osteosarcoma bone metastasis symptoms

The symptoms of osteosarcoma metastasis, osteosarcoma most commonly metastasizes to the lungs. If pulmonary metastasis occurs, there are at least two prominent characteristics. The first is that most metastatic tumors are located on the surface of the lungs and are rarely within the lung parenchyma, thus, they are not difficult to detect. The second point is that most metastatic tumors predominantly present as multiple bilateral lung metastases. Isolated unilateral lung metastasis is very rare. Therefore, this characteristic determines that osteosarcoma lung metastasis can only be managed with local wedge-shaped or segmental lung resections as the basic comfort measure. In fact, this simple surgical approach often allows for complete removal of the metastatic tumors while preserving most of the normal lung tissue.

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Written by Na Hong Wei
Orthopedics
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What is osteosarcoma?

Osteosarcoma is a type of malignant tumor that occurs in the bones, generally classified as stage IIb. Common sites for osteosarcoma include the distal part of the bone, the proximal tibia, and the proximal humerus. It most commonly affects adolescents. Clinically, it primarily presents as persistent pain, including nighttime pain. Swelling and limited joint function typically occur around the common sites. Additionally, there are general symptoms associated with cachexia, such as malnutrition, anemia, mild or high fever, or weight loss. Fourthly, it is very prone to causing pathological fractures. Many osteosarcoma patients seek medical attention due to these fractures. Thus, osteosarcoma is a serious malignancy in the bones with a generally poor prognosis. Diagnosis and treatment of osteosarcoma are crucial; upon confirmation, timely treatment is necessary. The primary treatment approach is a combination therapy centered around surgery, typically involving preoperative chemotherapy, followed by surgical treatment and postoperative chemotherapy. Currently, the five-year survival rate for osteosarcoma has significantly improved, reaching approximately 70% to over 80%.