Osteosarcoma
This rapidly growing tumor often
Definition:
● is a type of bone cancer that begins
in the cells that form bones.
Osteosarcoma is most often found in
the long bones — more often the
legs, but sometimes the arms — but
it can start in any bone. In very rare
instances, it occurs in soft tissue
outside the bone.
● Osteosarcoma, also called
osteogenic sarcoma, is the most
common type of cancer that starts
in the bones. The cancer cells in
these tumors look like early forms
of bone cells that normally help
make new bone tissue, but the
bone tissue in osteosarcoma are
not as strong as that in normal
bones.
○ Most osteosarcomas occur in
children, teens and young
adults
○ Most tumors develop in the
bones around the knee,
either in the lower part of the
thigh bone or the upper part
of the shin bone.
● The risk of getting osteosarcoma is
highest for those between the ages
of 10 to 30, especially during
teenage growth spurt.
● A common misconception is that
osteosarcoma is caused by injury,
but that is not true.
Symptoms:
Swelling, Bone or Joint Pain, Bone injury
or bone break for no clear reason
Types and Kinds:
● Telangiectatic osteosarcoma -
expands the contour of bone and
shows features of cortical disruption
with minimal or no periosteal new
bone formation.
● Small Cell Osteosarcoma - Is a
very rare type of osteosarcoma,
histologically mimicking other small
round cell malignancies of bone,
most notably Ewing sarcoma.
● High-grade Surface
Osteosarcoma - are sporadic and
high-grade malignant
osteoid-forming tumors emerging
from the bony surfaces
● Secondary Osteosarcoma - The
growth of abnormal bone in the
setting of various underlying
osseous disorders such as fractures,
scoliosis, osteoarthritis, etc.
● Low-grade Intraosseous
Osteosarcoma - well-differentiated,
sub-type of osteosarcoma, with
clinical, imaging, and histological
features in keeping with benign
tumours. Thus, initial misdiagnosis is
common, typically being mistaken
for fibrous dysplasia.
● Parosteal Osteosarcoma - is a
malignant, low-grade, osteosarcoma
that occurs on the surface of the
metaphysis of long bones. Patients
typically present between ages 30
and 40 with a painless mass.
● Periosteal Osteosarcoma - It
usually forms on the surface of
bones of the legs called the tibia and
femur. It also can form on the
surface of bones in the arms called
the ulna and the humeru

Causes:
● Osteosarcoma begins when a
healthy bone cell develops
changes in its DNA. A cell's DNA
contains the instructions that tell
a cell what to do. The changes tell
the cell to start making new bones
when it isn't needed. The result of
a mass (tumor) of poorly formed
bone cells that can invade and
destroy healthy body tissue. Cells
can break away and spread
(metastasize) throughout the
body.
Pathophysiology:
There are 4 Predisposing Factors
a. Growth Related such as Age. The
risk of osteosarcoma is highest for
those between the ages of 10 and
60, especially during the teenage
growth spurt. This suggests there
may be a link between rapid bone
growth and risk of tumor formation.
The risk goes down in middle age,
but rises again in older adults
(usually over the age of 60).
b. Somatic Alterations- alteration in
DNA that occurs after conception.
Somatic mutations can occur in any
of the cells of the body.
c. Germ Line Genetics- Li Fraumeni
syndrome, Retinoblastoma
syndrome, Werner syndrome ,
Bloom syndrome or
Diamond–Blackfan anemia . TP53 is
the most frequently altered gene in
osteosarcoma.
d. Environmental Factors- such as
radiation therapy.
For the Mechanism of the Osteosarcoma,
Alteration in the Osteoblastic of the
patient or in the formation of their bone cells
can be affected once there is a hinderance
dun sa activation of ng oncogene,
oncogene is a gene that is responsible with
the cell growth and proliferation or ung pag
divide ng mga cells throughout the body so
when there is a poorly formed bone cell, it
can invade the healthy body tissues.
Another is the deactivation of tumor
suppressor genes so these are usually the
products nung oncogenes so if meron
hindrance palang dun sa activation nya,
hindi nya ma-aactivate yung suppressor
genes which could lead to tumor
development and negative regualtory
proteins.
When the tumor development starts to
progress, the proliferation of malignant
osteoblast could spread to the patient’s
bone cell especially yung poorly developed
and the connective tissue as well.
So as the malignant osteoblast starts to
develop, formation of osteoid tissue can
happen, osteoid tissue is the unmineralized
bone which can cause breakness in a
specific bone of the patient. Once na
dumami yung formation of unmineralized
osteoid tissue, this can cause
overcrowding and breakness of other
connected bones in the body.
Complications sa pathophysiology
● Suppression of the bone marrow
which leads to a decreased
production of blood cells in the body
● Cancer cell will metastasis, which
could affect not only the bones but
also the different organs in the body
since poor na den yung protection
na nabibigay ng bones sa mga
different organs ni patient
● Increased pressure in the bone,
that can cause pain, swelling and
fracture for the patient.
Other complications:
1. Cancer that spreads
(metastasizes). Osteosarcoma can
spread from where it started to other
areas, making treatment and
recovery more difficult.
Osteosarcoma that spreads most
often spreads to the lungs and to
other bones.
2. Adapting to limb amputation.
Surgery that removes the tumor and
spares the limb is used whenever
possible. But sometimes it's
necessary to remove part of the
affected limb in order to remove all
of the cancer. Learning to use an
artificial limb (prosthesis) will take
time, practice and patience. Experts
can help you adapt.
3. Long-term treatment side effects.
The aggressive chemotherapy
needed to control osteosarcoma can
cause substantial side effects, both
in the short and long term. Your
health care team can help you
manage the side effects that happen
during treatment and provide you
Treatment
Osteosarcoma treatment typically involves
surgery and chemotherapy. Radiation
therapy might be an option in certain
situations wherein the malignant osteoblast
is aggressive. Surgeries that can be done
would be the following:
● Limb Sparing Surgery - If the
patient opts with this surgery, they
need to undergo chemotherapy to
make the cancer cells shrink then
will be easier to remove during
surgery.
● Surgery to remove the affected
limb (amputation)
● Surgery to remove the lower
portion of the leg (rotationplasty).
In this surgery, sometimes used for
children who are still growing, the
surgeon removes the cancer and
surrounding area, including the knee
joint. The foot and ankle are then
rotated, and the ankle functions as a
knee. A prosthesis is used for the
lower leg and foot. Results typically
enable the person to function very
well in physical activities, sports and
daily living.
Nursing Intervention:
● Provide a quiet environment and
calm activities to prevent or lessen
pain.
● Encourage diversional activities
● Encourage the patient to increase
fluid intake
● Encourage rest periods to prevent
fatigue
● Assess muscle strength, gross and
fine motor coordination.
● Provide pillows for cushion and
support.
● Keep side rails up all the time.
 s te os a r com
O a
Group 4 Section A - Zoie N. Sison
DEFINITION
Osteosarcoma, also called osteogenic
sarcoma, is the most common type of cancer
that starts in the bones. The cancer cells in
these tumors look like early forms of bone
cells that normally help make new bone
tissue, but the bone tissue in osteosarcoma
are not as strong as that in normal bones.
 SYMPTOMS

BONE OR BONE BONE BREAK FOR

SWELLING
JOINT PAIN INJURY NO REASON
 Types of
osteosarcoma

Telangiectatic Small Cell High-grade Surface

Osteosarcoma Osteosarcoma Osteosarcoma
 Types of
osteosarcoma

Secondary Low-grade Parosteal Parosteal

Osteosarcoma Intraosseous Osteosarcoma Osteosarcoma
Osteosarcoma
 CAUSES
Osteosarcoma begins when a healthy bone cell develops
changes in its DNA. A cell's DNA contains the
instructions that tell a cell what to do. The changes tell
the cell to start making new bones when it isn't needed.
The result of a mass (tumor) of poorly formed bone cells
that can invade and destroy healthy body tissue. Cells
can break away and spread (metastasize) throughout the
body.
 PATHOPHYSIOLOGY

LEGENDS: PREDISPOSING FACTORS & COMPLICATION MECHANISM INTERNAL FACTORS

 OTHER
COMPLICATIONS
CANCER THAT SPREADS ADAPTING TO LIMB
(MESTASTASIZES) AMPUTATION

LONG-TERM TREATMENT
SIDE EFFECTS
 TREATMENT
SURGERY TO REMOVE LIMB SPARING SURGERY
THE AFFECTED LIMB
(AMPUTATION)

CHEMOTHERAPY

SURGERY TO REMOVE THE

LOWER PORTION OF THE RADIATION
LEG (ROATIONPLASTY) THERAPY
NURSING INTERVENTION
Provide a quiet environment and calm activities to prevent or
lessen pain.
Encourage the patient to increase fluid intake
Encourage rest periods to prevent fatigue
Provide accurate information about the situation, medication
and treatment.
Assess muscle strength, gross and fine motor coordination.
Provide pillows for cushion and support.
Keep side rails up all the time.
 h a n k You
T for listening