MedlinePlus Medical Encyclopedia: Osteosarcoma

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Osteosarcoma

Contents of this page:
Illustrations Alternative names Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Support Groups Expectations (prognosis) Complications Calling your health care provider

Illustrations

X-ray

Osteogenic sarcoma - X-ray

Ewings sarcoma - X-ray

Bone tumor

Alternative names Return to top

Osteogenic sarcoma

Definition Return to top

Osteosarcoma is a malignant bone tumor that usually develops during the period of rapid growth which occurs in adolescence as a teenager matures into an adult.

Causes, incidence, and risk factors Return to top

Osteosarcoma is the most common malignant bone tumor in youth. The average age at diagnosis is 15. Boys and girls have a similar incidence of this tumor until late adolescence, at which time boys are more commonly affected.

The cause is not known. In some cases, osteosarcoma runs in families and at least one gene has been linked to increased risk. This gene is also associated with familial retinoblastoma, a cancer of the eye which occurs in children. It appears to be a defective tumor inhibitor gene.

Osteosarcoma tends to occur in the bones of the thigh (distal end, near the knee), upper arm (proximal end, near the shoulder), and shin (proximal end, near the knee). This cancer occurs most commonly in larger bones and in the area of bone with fastest growth rate. Osteosarcoma can occur in any bone, however.

The most common symptom initially is pain. As the tumor grows, there may be visible swelling and limitation of motion. Tumors in the legs cause limping, while those in the arms cause pain on lifting. Swelling over the tumor may be warm and slightly reddened.

Symptoms Return to top

Bone pain.
Tenderness, swelling, or redness at the site of the bone pain.
The first sign may be a bone fracture. The tumor may cause weakness in the affected area of the bone. A fracture at the site of the tumor is called a "pathological fracture" which occurs after what often seems like a routine movement. For example, a young athlete who breaks an arm during a routine throw should be tested to ensure there is no underlying bone problem, such as a tumor or cyst.

Signs and tests Return to top

X-ray of the affected area
CT scan of the affected area
Blood tests
CT of the chest to see if the cancer has spread to the lungs
Open biopsy (at time of surgery for diagnosis)
Bone scan to see if the cancer has spread to other bones

Treatment Return to top

Prior to surgery, chemotherapy is given. This is strong medication, injected intravenously (into the vein) to make the tumor shrink. Surgery is then used to remove any remaining tumor, while attempting to spare the affected limb. Chemotherapy also treats any cancer cells which may have spread to other parts of the body.

Limb-saving surgery is usually possible, but more radical surgery (such as amputation) may be necessary for a permanent cure.

Common chemotherapy medicines include:

High dose methotrexate with leucovorin
Doxorubicin (Adriamycin)
Cisplatin
Carboplatin (Paraplatin)
Cyclophosphamide (Cytoxan)
Ifosfamide (Ifex)

Support Groups Return to top

Association of Cancer Online Resources
www.acor.org

The National Childhood Cancer Foundation (NCCF)
www.nccf.org

Expectations (prognosis) Return to top

In the absence of pulmonary metastasis (spread of the tumor to the lungs), long-term survival may reach 70%. If the cancer has spread to other parts of the body besides the bone where it started, permanent cure is less likely, but can sometimes still be achieved.

Complications Return to top

Limb removal
Lung metastases
Effects of chemotherapy vary for each person and depend on the specific chemotherapy given

Calling your health care provider Return to top

Call your health care provider if bone pain, tenderness, or swelling occur.

Update Date: 4/23/2004

Updated by: Samuel Blackman, M.D., Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH. Review provided by VeriMed Healthcare Network.

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