Osteosarcoma

Osteosarcoma is the most common malignant bone tumor after myeloma and is predominantly male (1.5: 1). More than 75% of cases appear in young patients, under 25 years of age. Fortunately, evildoers are rare, but we should not lower our guard ...

What is it

The term “osteosarcoma” is applied to a heterogeneous group of malignant tumors which have as a common feature immature bone formation ("Osteoid"). It's a tumor very aggressive locally and can metastasize to the lungs and bone itself.

It is a tumor that is usually located at the ends of the bones (metaphysis) most often around the knee. About half of the tumors occur in the femur and less frequently in the tibia and fibula, humerus, pelvis, jaw, and ribs. The most frequent subtype is the “classic osteosarcoma”(90% of cases) with their varieties:

• Osteoblastic (45% of cases)
• Chondroblastic (27%)
• Fibroblastic (9%)
• Anaplastic (7%)

What Causes Osteosarcoma?

The cause of osteosarcoma is diverse and not yet fully understood. The following have been defined Causes:

• Hereditary genetic factors.
• Exposure to ionizing radiation for therapeutic purposes (radiotherapy).
• History of suffering from diseases such as Paget's disease, bone infarcts (necrosis), chronic osteomyelitis (chronic bone infection) ...

Osteosarcoma symptoms

The symptoms that usually appear due to an osteosarcoma are:

• Bone pain: it is the first symptom, with or without palpation of mass in the area.
• Bone fracture (which happens spontaneously or after an apparently innocent movement).
• Limp (if the tumor affects the lower limb).
• Swelling, redness, swelling or increased sensitivity in the skin in the area where the tumor is located.

The appearance of fever, poor general condition and other constitutional symptoms they are not typical of osteosarcoma.

In younger children, lameness may be the only symptom. pain can be present for many months and may initially be mistaken for more common causes such as muscle spasms or "growing pains."

How to diagnose an osteosarcoma?

A medical history with Comprehensive history and physical examination of the entire patient. It will also be necessary to carry out supplementary tests as a blood test or hemogram and biochemistry, which includes especially calcium and phosphorus ions, alkaline phosphatase (FA), lactate dehydrogenase (LDH), etc. Also the imaging tests What:

• Bone x-ray: in most cases it is practically diagnostic.
• CT and MRI: the first better details the magnitude or extent of bone destruction while the second assesses the component of adjacent soft tissue involvement (neurovascular structures).
• Bone scan and PET (positron emission tomography): additional techniques are also useful, more in staging (presence or absence of metastases) than in primary diagnostic evaluation.
• Histological biopsy study techniques (observation of the tissue under a microscope): the defining test of osteosarcoma is the visualization of osteoblastic spindle cells of evident malignancy, producing osteoid material.

Important! pain that is not resolved with conventional measures, its persistence in the patient's resting state or the one that awakens him at night, must be due to the need to carry out a more detailed and in-depth study.

How is it cured?

• Surgery: it is the method of choice, in the past, radical amputation was the only possible option, but currently the choice is conservative surgery (removing only the tumor area with a few centimeters of healthy tissue margin).
• (QT) should be used prior to surgery.
• (RT) has poor efficacy and few indications.

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