Gunio, Lavarez, Peraz, Villanueva

Osteosarcoma
Case Presentation
Group 6
 Objectives of the Presentation

• Ensure that the audience comprehensively understands the medical

condition, including its pathophysiology, clinical manifestations, and
relevant diagnostic criteria.
• Explain the diagnostic process undertaken, including the differential
diagnosis considered, the rationale behind diagnostic tests ordered,
and the interpretation of results.
• Understand the treatment plan implemented for the patient,
including pharmacological interventions, surgical procedures, and
non-pharmacological therapies, along with the rationale for each.
 Objectives of the Presentation

• Discuss the prognosis of the medical condition, including potential

complications and expected outcomes. Outline the follow-up plan,
including monitoring parameters and any necessary adjustments to
the treatment plan.
• Acknowledge the contributions of other healthcare professionals
involved in the patient's care, such as nurses, therapists, and
specialists, emphasizing the collaborative nature of healthcare
delivery.
• Provide opportunities for audience members to engage in discussion,
ask questions, and contribute their insights.
 Osteosarcoma is a type of bone cancer that
usually develops in the osteoblast cells that
Introduction form bone. It happens most often in
children, adolescents, and young adults.
Osteosarcoma most commonly happens in
What is the long bones around the knee. Other sites
for osteosarcoma include the upper leg, or
osteosarcoma? thighbone, the lower leg, upper arm bone,
or any bone in the body, including those in
the pelvis, shoulder, and skull.
Osteosarcoma may grow into nearby
tissues, such as tendons or muscles. It may
also spread, or metastasize, through the
bloodstream to other organs or bones in the
body.
Introduction
What is
osteosarcoma?
 Causes

The cause of most osteosarcomas

is not clear at this time. However,
researchers have found that
osteosarcoma is linked with a
number of other conditions, which
are described in risk factors.
 • Lifestyle-related risk
factors
Risk Factors • Age
• Height
• Sex
• Race / Ethnicity
• Radiation to Bones
• Certain Bone Disease
• Inherited Cancer
Syndrome
Morbidity and Mortality rate

The survival rates for osteosarcoma vary

based on several factors. These include the
stage of cancer, a person’s age and general
health, and how well the treatment plan
works. Other factors that can affect
outcomes include the type and subtype of
the cancer.
If osteosarcoma is diagnosed and treated
before it can be detected outside the area
where it started, the
Morbidity and Mortality rate

5-year relative survival rate for people of all

ages is 76%. If the cancer has spread outside
of the bones and into the regional lymph
nodes, the 5-year relative survival rate is
64%. If the cancer has spread to distant parts
of the body, the 5-year relative survival rate
is 24%.
Anatomy & Physiology
2 Main Regions
diaphysis
tubular shaft that runs between the proximal and distal ends of a long
bone
epiphysis
wide section at each end of a long bone; filled with spongy bone and red
marrow

endosteum
contains layer of bone cells; Lining the inside of the bone adjacent to the
medullary cavity
periosteum
outermost layer of a bone; an outer fibrous layer of dense irregular
connective tissue
 Anatomy &
Physiology
articular cartilage
thin layer of cartilage covering an epiphysis; reduces friction
and acts as a shock absorber
metaphysis
where the epiphysis meets the diaphysis; contains the
epiphyseal plate
epiphyseal plate
(also, growth plate) sheet of hyaline cartilage in the
metaphysis of an immature bone; replaced by bone tissue as
the organ grows in length
 Anatomy & Physiology
osteoblast
cell responsible for forming new bone
osteoclast
cell responsible for resorbing bone
osteocyte
primary cell in mature bone; responsible for maintaining the
matrix
osteogenic cell
undifferentiated cell with high
mitotic activity; the only bone cells
that divide; they differentiate and
develop into osteoblasts
 Anatomy & Physiology
• Support and Locomotion: The skeleton provides a rigid framework for the body,
supporting organs, and enabling movement through muscles attached to bones.
• Mineral Storage and Homeostasis: Bones act as a reservoir for calcium and
phosphate, essential minerals for various bodily functions. They can release or
absorb these minerals as needed to maintain blood calcium levels.
• Protection: Bones form a protective cage around vital organs like the brain, heart,
and lungs, shielding them from injury.
• Hematopoiesis: Red bone marrow within bones is responsible for producing red
blood cells, white blood cells, and platelets, vital components of the blood system.
Signs & While pain and swelling are often the earliest and
most common signs of osteosarcoma, this
Symptoms malignancy can cause a number of other symptoms,
including:
• A bump, depending on where the tumor is
located
• Redness and warmth at the site of the tumor
• Anemia
• Fever
• Decreased movement of the affected limb
• Unexplained weight loss
Less commonly, osteosarcoma can lead to a bone
fracture when the tumor has caused a bone to
weaken to the extent that it breaks.
Laboratory / Diagnostic Tests

• X - ray
• Bone Scan
• Magnetic Resonance Imaging
(MRI)
• Computed Tomography Scan (also
called CT or CAT Scan)
• Positron Emission Tomography
(PET Scan)
• Complete Blood Count (CBC)
• Other blood tests
• Biopsy of the tumor
 Treatment
• Surgery: During surgery, the tumor and some of the healthy tissue
around it will be cut out of the affected bone. In most cases
involving the arm or leg, surgery can be done without amputation.
This is called limb-salvage surgery. These procedures may be
possible in those whose cancer has not spread beyond its original
site.
• Chemotherapy: This is the use of drugs to kill cancer cells.
Chemotherapy is given before surgery to shrink the tumor and kill
any cancer cells floating around in the blood, and after surgery to
catch any cancer cells that might still be in your body.
 Treatment
• Radiation therapy: There are two types: external radiation therapy
and internal radiation therapy. The external kind uses a machine that
points radiation at the area of the body that is cancerous. Internal
radiation therapy is where the substance is inserted via needle or
catheter.
• Targeted therapy: Targeted therapy is the use of drugs that block
certain proteins that are important to cancer cells.
• Cryosurgery: Liquid nitrogen is used to freeze and destroy cancer
cells.
 Treatment
• Amputation: Amputation is the surgical removal of a limb.
• Rotationplasty: This procedure is used on tumors of the distal femur,
which is the area of the leg just above the knee. The leg is partially
amputated, the tumor is removed and then the lower leg is rotated
180 degrees and reattached, using the ankle as a new knee. This
converts the above-knee to a below-knee amputation that is more
functional and helps fit a prosthesis. Your healthcare provider will
discuss the cosmetic side effects if a rotationplasty is an option.
 Nursing Management
• Nonpharmacologic pain management techniques are used to relieve and
increase the patient’s comfort level such as applying warm or cold
compress on the affected area alternately (heat helps decrease pain an
muscle spasm and col helps decrease swelling and pain.)
• The affected extremities must be supported and handled gently to prevent
pathological fractures.
• Give external supports such as splints for additional protection on the
affected part.
• Provide rehabilitation that may include physical and occupational
therapy, teaches exercise to help to decrease pain.
• Provide full explanation of the possible side effects associated with
chemotherapy and radiation therapy.
Pathophysiology
of
Osteosarcoma
 References
• https://www.cancer.org/cancer/types/osteosarcoma/causes-risks-
prevention/risk-factors.html
• https://www.hopkinsmedicine.org/health/conditions-and-diseases/
sarcoma/osteosarcoma
• https://www.cancer.org/cancer/types/osteosarcoma/treating/
chemotherapy.html#:~:text=The%20drugs%20used%20most
%20often,Cisplatin%20or%20carboplatin
• https://www.cancer.org/cancer/types/osteosarcoma/causes-risks-
prevention/what-causes.html
• https://www.moffitt.org/cancers/osteosarcoma/faqs/what-are-the-
first-signs-of-osteosarcoma/
• https://open.oregonstate.education/aandp/chapter/6-3-bone-structure/
Thank you for your attention