JULIANA ROSE A.

GENERAL
NR31

SLIDE 1:
OSTEOSARCOMA
'Osteo' comes from an ancient Greek word for bone. 'Sarcoma' is the name given to cancers that start in connective or
supporting tissues, such as bone, fat, cartilage, blood vessels and muscle.

A type of bone cancer that arises from osteoid tissue, which is the substance found in growing bone. It primarily affects the
long bones, such as those in the arms and legs, but it can occur in any bone. Osteosarcoma usually develops in children and
young adults, particularly during periods of rapid growth.

OSTEOID TISSUE is produced by osteoblasts, which are bone-forming cells located in the outer layer of bone tissue
known as the periosteum, as well as within the bone matrix itself. During Ossification (bone formation), osteoblasts secrete
osteoid tissue, which serves as a scaffold for the deposition of calcium and phosphate minerals. These minerals eventually
crystallize within the osteoid matrix, forming hydroxyapatite crystals, which give bone its hardness and strength.

Osteoid tissue is crucial for bone growth, repair, and remodeling. It provides the structural framework necessary for the
formation of new bone tissue during growth and development, as well as in response to injury or stress. Additionally,
osteoid tissue plays a role in the regulation of bone metabolism and mineral homeostasis within the body.

SLIDES 2-4
The majority of osteosarcomas arise from a single place within the area of a long bone known as the metaphysis or 'neck' of
a long bone. The metaphysis contains the area of the bone where cells are growing and dividing.

The long bones of the skeleton are bones that are longer than they are wide, for example the thigh bone (femur) or the upper
arm bone (humerus). Half of osteosarcoma cases occur in the long bones of the lower body.

Multi-focal osteosarcoma - osteosarcoma that starts in more than one bone at the same time.

The three areas most often affected by osteosarcoma are:

 The lower thigh bone nearest to the knee (distal femur)
 The upper shin bone nearest to the knee (proximal tibia)
 The upper arm bone nearest to the shoulder (proximal humerus)
 Other bones can be affected such as the jaw, spine and the pelvis.

LONG BONES
 Metaphysis Area - where growth occurs during childhood and adolescence. Rapid bone growth and remodeling in this
region may predispose it to the development of osteosarcoma.
 High Metabolic Activity - Long bones plays a role in supporting body weight and facilitating movement. This
increased metabolic activity may create a more favorable environment for the development of cancerous cells.
 Rich Blood Supply - The abundant blood flow may facilitate the growth and spread of cancerous cells within the bone
and to other parts of the body.
 Stress - Long bones are subjected to mechanical stresses such as bending, torsion, and compression during everyday
activities. These stresses can lead to microtrauma or damage to the bone tissue, which may increase the risk of genetic
mutations and the development of osteosarcoma.
 Bone Growth - During periods of rapid bone growth, such as during childhood and adolescence, there is increased
cellular activity and turnover in the metaphyseal region of long bones. This heightened activity may predispose these
areas to errors in cellular regulation and the development of cancerous growths like osteosarcoma.

Tumours found in the bones of the face, skull and spine are more common in older osteosarcoma patients than
younger osteosarcoma patients.

SLIDES 5-7
ANATOMY AND PHYSIOLOGY

Anatomy of Bone Tissue:

 Bones are made up of several layers:
Compact bone (dense and hard). The outer layer. Provide strenght, support,
protection.
Spongy bone (less dense with a honeycomb-like structure). The inner layer,
provides support and reducing bone weight, contains red bone marrow in
blood cell production.
Epiphyseal Line - Marks the location where growth plates.
Red Bone Marrow: Site of hematopoiesis (blood cell formation), including
red blood cells, white blood cells, and platelets. Contains hematopoietic stem
cells responsible for replenishing blood cell populations. Found in flat bones,
irregular bones, and the epiphyses of long bones.
Hyaline Cartilage: Provides a smooth surface for joint movement. Acts as a
cushion between bones to absorb shock. Forms the template for bone growth
during development.

 Bone tissue is composed of cells called osteoblasts, osteocytes, and osteoclasts,

along with a matrix of collagen fibers and mineral salts, primarily calcium and
phosphate.

Osteoblasts are responsible for synthesizing new bone tissue.

Osteocytes are mature bone cells embedded within the bone matrix.
Osteoclasts are involved in the breakdown and remodeling of bone tissue.
Physiology of Bone Tissue:
 Bone tissue is dynamic and undergoes constant remodeling throughout life. This process involves the coordinated
action of osteoblasts and osteoclasts.
 Osteoblasts deposit new bone tissue in areas where it is needed, while osteoclasts break down and resorb old or
damaged bone tissue.
 This remodeling process helps maintain bone strength and integrity, repair damage, and respond to mechanical
stressors.
 Bone growth occurs primarily during childhood and adolescence, as new bone tissue is added at the growth plates
(epiphyseal plates) located at the ends of long bones.

KEYPOINTS
 Most of the body’s minerals are stored in the bones
 Diet and lifestyle can affect the quality of bone formation
 Even after formed they undergo constant remodelling
 Changes in the remodelling process can result in pathology
 Bones provides the body with structural support and enabling movement

SLIDES 8-9

SLIDE 10 -13
Relationship to Osteosarcoma:
 Osteosarcoma arises from abnormal proliferation of osteoblasts or
osteoblast precursor cells.
 The tumor typically develops in the metaphysis, the region of the bone
located adjacent to the growth plate, where rapid bone growth occurs.
 Osteosarcoma disrupts the normal balance of bone remodeling and leads
to the formation of a mass of abnormal bone tissue within the bone.
 As the tumor grows, it can weaken the bone structure and cause
symptoms such as pain, swelling, and fractures.

Osteosarcoma behaves in an aggressive manner, which means it can

spread in the bloodstream from or through the bone and into other places in
the body. The most common place for it to spread to is the lungs. It can also
spread to other places in the body including other bones. Because
osteosarcoma can spread to other parts of the body quickly, patients need
treatment to the whole body. This is called systemic treatment.

Localized osteosarcoma means that there is a tumor in only 1 place.

Metastatic osteosarcoma means that the cancer has spread to other places.

PATHOPHYSIOLOGY
Osteosarcoma develops from primitive bone-forming mesenchymal cells that undergo Genetic Mutations
malignant transformation. Genetic alterations, including mutations in tumor suppressor genes ↓
(such as TP53 and RB1) and oncogenes (such as MYC and MET), contribute to the Osteoblast Precursor Cells
dysregulation of cell proliferation and differentiation. The malignant cells produce osteoid, ↓
leading to the formation of irregular bone matrix within the tumor. Osteosarcoma is Uncontrolled Proliferation
characterized by local invasion into surrounding tissues and has a propensity for metastasis, ↓
particularly to the lungs. Primary Tumor
↓
1. Genetic mutations occur in osteoblast precursor cells. Disruption of Bone Structure
2. Mutated cells proliferate uncontrollably. ↓
3. Formation of a primary tumor within the bone, typically in the metaphysis. Invasion of Surrounding Tissues
4. Tumor disrupts normal bone structure and integrity. ↓
5. Invasion of surrounding tissues and structures. Metastasis
6. Possible metastasis to other parts of the body, such as the lungs or other bones.
Osteosarcoma starts when one bone cell becomes abnormal and grows out of control to form a lump of cancerous tissue
known as a tumour. The cells in the tumour still act like bone, in that they try to create new bone as they grow and divide.

SLIDE 14 -15

SYMPTOMS OF OSTEOSARCOMA Symptoms may include:

Osteosarcoma damages and weakens the bone. Symptoms depend on where the
tumor is located. They may be hard to notice at first. They can also be like  Pain in a bone or joint
symptoms of other conditions.  Problems moving the joint
 A lump or swelling over a bone
Treatment typically involves a combination of surgery to remove the tumor and  Limping or problems walking
chemotherapy to kill any remaining cancer cells. Early detection and treatment are  A bone that breaks
essential for better outcomes.

RISK FACTORS FOR OSTEOSARCOMA

Osteosarcoma typically develops after age 10. It is rare before the age of 5.

These factors may increase risk for osteosarcoma:

 Osteosarcoma is slightly more common in males than females. influenced by several factors, including hormonal
differences, growth spurts, and genetic predisposition
 Cancer survivors who were treated with radiation therapy have a higher risk for developing osteosarcoma. Exposure to
ionizing radiation, such as that used in radiation therapy for cancer treatment, can damage DNA and increase the risk
of developing secondary cancers, including osteosarcoma. The risk is particularly elevated in individuals who received
radiation therapy at a young age and at high doses.
 Genetic factors may increase risk for osteosarcoma. A small number of children have changes in genes that put them at
higher risk for some cancers. Genetic alterations can disrupt normal cellular processes and increase the likelihood of
malignant transformation.

People at a higher risk include those with:

 Retinoblastoma that is passed down through families. This is because the same genetic mutation that predisposes
individuals to retinoblastoma (mutation in the RB1 gene) can also increase the risk of developing osteosarcoma.
 A history of multiple cancers. Certain cancer treatments, such as radiation therapy and certain chemotherapy agents,
may also increase the risk of secondary cancers, including osteosarcoma.

A strong family history of : Breast cancer Leukemia Brain tumor Tumors in bones or soft tissues

If a pathologist can see new bone (known as osteoid) in a tumour sample under the microscope, this helps to confirm a
diagnosis of osteosarcoma.

REFERENCES:
https://www.bcrt.org.uk/information/information-by-type/osteosarcoma/
https://together.stjude.org/en-us/about-pediatric-cancer/types/osteosarcoma.html
https://courses.lumenlearning.com/suny-ap1/chapter/bone-structure/