OSTEOSARCOMA

DEFINITION AND CHARACTERISTICS :

Osteosarcoma is a cancerous tumor that occurs in the bone.

Most osteosarcomas appear in the long bones of the body, such as the femur
(the thigh bone), the tibia (the shinbone) or the humerus (the bone that runs from
the shoulder to the elbow), although they can appear in any bones.

Although other types of cancer can eventually spread to parts of the

skeleton, osteosarcoma is one of the few that actually begin in bones and
sometimes spread (or metastasize) elsewhere, usually to the lungs or other
bones.

Because osteosarcoma usually develops from osteoblasts (the cells that

make growing bone), it most commonly affects teens who are experiencing a
growth spurt. Boys are more likely to have osteosarcoma than girls, and most
cases of osteosarcoma involve the knee.

Osteosarcoma is most commonly found in adolescents and young adults. About

60% of cases occur in people between 10 and 20 years of age.

CLASSIFICATIONS

The classification of osteosarcoma is based on a variety of

characteristics including its histologic features, biologic potential
(grade), relationship to bone of origin (surface or intramedullary),
multiplicity (solitary and multifocal) and the pre-existing state of
underlying bone (primary or secondary. The vast majority of
osteosarcomas can be categorized into three important groups: 1)
conventional osteosarcoma and its histologic subtypes, 2)
intramedullary well-differentiated osteosarcoma, and 3) surface
osteosarcomas. Conventional osteosarcoma, namely garden-variety
osteosarcoma, is solitary, arises in the medullary cavity of an
otherwise normal bone, is high-grade and produces neoplastic bone
with or without cartilaginous or fibroblastic components. Approximately
75%-80% of osteosarcomas are the conventional type, 5-10% are
juxtacortical in origin, 10% are secondary and arise in a diseased
bone, and 1% are intramedullary and well-differentiated.

Table 1: Classification of Osteosarcoma

Histologic features
osteoblastic
chondroblastic
fibroblastic
 telangiectatic
small cell
giant cell rich
epithelioid
Biologic potential
low grade
intermediate grade
high grade
Relationship to bone of origin
intramedullary
juxtacortical or surface
parosteal, periosteal, high grade surface
intracortical
Multiplicity
solitary
multifocal
synchronous
metachronous
State of underlying bone
primary (bone normal)
secondary (bone abnormal)
radiation, Paget's disease, infarction, osteomyelitis, prosthesis, pre-existing benign neoplasm

SIGNS AND SYMPTOMS

The symptoms of osteosarcoma can vary, depending on the bone in which the
cancer develops. Symptoms may include:

 Pain in the bone or joint that gets worse over time

 A painless swelling or a noticeable mass in the arm or leg
 A broken bone that occurs without or with minimal injury or trauma
 Stiffness or swelling of joints (uncommon)
 Back pain or loss of bowel or bladder control related to a tumor in the pelvis
or at the base of the spine. This is very rare the first sign that a child has
osteosarcoma.