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Osteosarcoma

Osteogenic sarcoma; Bone tumor - osteosarcoma

 

Osteosarcoma is a very rare type of cancerous bone tumor that usually develops in teenagers. It often occurs when a teen is growing rapidly.

Causes

 

Osteosarcoma is the most common bone cancer in children. Average age at diagnosis is 15. Boys and girls are just as likely to develop this tumor until the late teens, when it occurs more often in boys. Osteosarcoma is also common in people over age 60.

The cause is not known. In some cases, osteosarcoma runs in families. At least one gene has been linked to an increased risk. This gene is also associated with familial retinoblastoma. This is a cancer of the eye that occurs in children.

Osteosarcoma tends to occur in the bones of the:

  • Shin (near the knee)
  • Thigh (near the knee)
  • Upper arm (near the shoulder)

Osteosarcoma occurs most commonly in large bones in the area of bone with the fastest growth rate. However, it can occur in any bone.

 

Symptoms

 

The first symptom is usually bone pain near a joint. This symptom may be overlooked because of other more common causes of joint pain.

Other symptoms may include any of the following:

  • Bone fracture (may occur after a routine movement)
  • Limitation of motion
  • Limping (if the tumor is in the leg)
  • Pain when lifting (if the tumor is in the arm)
  • Tenderness, swelling, or redness at the site of the tumor

 

Exams and Tests

 

The health care provider will perform a physical exam and ask about the medical history and symptoms.

Tests that may be done include:

  • Biopsy (at time of surgery for diagnosis)
  • Blood tests
  • Bone scan to see if the cancer has spread to other bones
  • CT scan of the chest to see if the cancer has spread to the lungs
  • MRI scan
  • PET scan
  • X-ray

 

Treatment

 

Treatment usually starts after a biopsy of the tumor is done.

Before surgery to remove the tumor, chemotherapy is usually given. This can shrink the tumor and make surgery easier. It may also kill any cancer cells that have spread to other parts of the body.

Surgery is used after chemotherapy to remove any remaining tumor. In most cases, surgery can remove the tumor while saving the affected limb. This is called limb-sparing surgery. In rare cases, more involved surgery (amputation) is necessary.

 

Support Groups

 

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you and your family not feel alone.

 

Outlook (Prognosis)

 

If the tumor has not spread to the lungs (pulmonary metastasis), long-term survival rates are better. If the cancer has spread to other parts of the body, the outlook is worse. However, there is still a chance of cure with effective treatment.

 

Possible Complications

 

Complications may include:

  • Limb removal
  • Spread of cancer to the lungs
  • Side effects of chemotherapy

 

When to Contact a Medical Professional

 

Call your provider if you or your child has persistent bone pain, tenderness, or swelling.

 

 

References

Anderson ME, Randall RL, Springfield DS, Gebhardt MC. Sarcomas of bone. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 92.

National Cancer Institute. Osteosarcoma and malignant fibrous histiocytoma of bone treatment (PDQ) - health professional version. Cancer.gov Web site. Updated December 2, 2016. www.cancer.gov/cancertopics/pdq/treatment/osteosarcoma/HealthProfessional. Accessed December 21, 2016.

 
  • X-ray

    X-ray - illustration

    X-rays are a form of ionizing radiation that can penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray depending on density. X-rays can provide information about obstructions, tumors, and other diseases, especially when coupled with the use of barium and air contrast within the bowel.

    X-ray

    illustration

  • Osteogenic sarcoma - X-ray

    Osteogenic sarcoma - X-ray - illustration

    This x-ray shows a malignant bone tumor (osteogenic sarcoma) of the knee. This type of tumor is usually seen in adolescents (around 15 years old). This tumor extends from the bone into the surrounding tissue.

    Osteogenic sarcoma - X-ray

    illustration

  • Ewings sarcoma - X-ray

    Ewings sarcoma - X-ray - illustration

    This x-ray shows a malignant bone tumor (Ewing sarcoma) of the upper arm bone (humerus). This type of tumor usually occurs during childhood and adolescence.

    Ewings sarcoma - X-ray

    illustration

  • Bone tumor

    Bone tumor - illustration

    An abnormal growth of cells within the bone that may be benign or malignant (cancerous).

    Bone tumor

    illustration

    • X-ray

      X-ray - illustration

      X-rays are a form of ionizing radiation that can penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray depending on density. X-rays can provide information about obstructions, tumors, and other diseases, especially when coupled with the use of barium and air contrast within the bowel.

      X-ray

      illustration

    • Osteogenic sarcoma - X-ray

      Osteogenic sarcoma - X-ray - illustration

      This x-ray shows a malignant bone tumor (osteogenic sarcoma) of the knee. This type of tumor is usually seen in adolescents (around 15 years old). This tumor extends from the bone into the surrounding tissue.

      Osteogenic sarcoma - X-ray

      illustration

    • Ewings sarcoma - X-ray

      Ewings sarcoma - X-ray - illustration

      This x-ray shows a malignant bone tumor (Ewing sarcoma) of the upper arm bone (humerus). This type of tumor usually occurs during childhood and adolescence.

      Ewings sarcoma - X-ray

      illustration

    • Bone tumor

      Bone tumor - illustration

      An abnormal growth of cells within the bone that may be benign or malignant (cancerous).

      Bone tumor

      illustration

    Tests for Osteosarcoma

     

       

      Review Date: 11/10/2016

      Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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