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 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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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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Written by Wang Cheng Lin
Orthopedics
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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.

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Written by Guan Yu Hua
Orthopedic Surgery
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Why does osteosarcoma not hurt?

Osteosarcoma usually presents with pain, which is often severe, persistent, and most pronounced at night. The local skin temperature may also increase, accompanied by venous obstruction. It is a malignant tumor of the bone, most commonly located near the proximal part of the tibia or the distal part of the femur. The main symptom is pain, and a definite diagnosis can be made through radiographic examination, such as sunlight exposure, Codman's triangle, etc. In its early stages, osteosarcoma can metastasize. If there is no pain, it may be due to individual variations in the disease. However, the first symptoms of malignant bone tumors are usually pain and a palpable mass. Radiographic examinations will show changes. If osteosarcoma is confirmed and there is no pain, it could be related to the disease not having progressed to a more severe stage, possibly indicating an early stage. Early aggressive surgical treatment is recommended, such as limb-sparing surgery, devitalization and reimplantation, or prosthetic implantation. Another option is amputation. Osteosarcoma has a relatively high chance of metastasizing to the lungs; therefore, early surgery, early diagnosis, and rapid chemotherapy are essential, as these can significantly increase the five-year survival rate.

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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.