OSTEOSARCOMA

Osteosarcoma is a cancerous (malignant) bone tumor that usually develops during the period of rapid growth that occurs in adolescence, as a teenager matures into an adult. Causes, incidence, and risk factors Osteosarcoma is the most common cancerous (malignant) bone tumor in youth. The average age at diagnosis is 15. Boys and girls have a similar incidence of this tumor until late adolescence, at which time boys are more commonly affected. There is another peak in incidence among adults in their 60s and 70s. 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 Figure 1: Osteosarcoma is a type of bone cancer that begins in the cells that form the bone. Osteosarcoma occurs most often in familial retinoblastoma, a cancer of the eye that the long bones of the arms and legs. occurs in children. Osteosarcoma tends to occur in the bones of the:
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Shin (near the knee) Thigh (near the knee) Upper arm (near the shoulder)

This cancer occurs most commonly in larger bones and in the area of bone with the fastest growth rate. Osteosarcoma can occur in any bone, however. Symptoms
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Bone fracture (may occur after what seems like a routine movement) Bone pain 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
Figure 2: A clinical photograph of a large mass of the distal femur (just above the knee). While this represents the most common location of osteosarcoma, such an obvious mass is not always evident.

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Signs and tests y Biopsy (at time of surgery for diagnosis) y y y y y 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 CT scan of the affected area X-ray of the affected area
Figure 3: AP and Lateral X-Rays of the mass seen in Figure 1. Notice the bone formation within this mass. These pictures are virtually diagnostic of Osteosarcoma.

Treatment Treatment usually starts after a biopsy of the tumor is done. Before major surgery to remove the tumor, chemotherapy is usually given. This can shrink the tumopr and it makes surgery easier. It also may 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-salvage surgery). Rarely, more radical surgery (such as amputation) may be necessary.

Expectations (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, prognosis is better but there is still a chance of cure with effective treatment. Complications y y y Limb removal Spread of cancer to the lungs Side effects of chemotherapy