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Overview of Osteosarcoma

Osteosarcoma is a highly malignant bone tumor that is most common in children and adolescents. It arises from bone tissue and spreads rapidly. The long bones, especially around the knee, are most commonly affected. Symptoms include pain, swelling, and pathological fractures. Diagnosis involves imaging like x-rays, MRI, CT, and bone scans. Treatment consists of chemotherapy combined with surgery such as limb salvage or amputation, depending on the location and severity of the cancer. Limb salvage surgery aims to remove the tumor while preserving limb function through bone grafting or prosthetic reconstruction.

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Bakta Giri
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185 views24 pages

Overview of Osteosarcoma

Osteosarcoma is a highly malignant bone tumor that is most common in children and adolescents. It arises from bone tissue and spreads rapidly. The long bones, especially around the knee, are most commonly affected. Symptoms include pain, swelling, and pathological fractures. Diagnosis involves imaging like x-rays, MRI, CT, and bone scans. Treatment consists of chemotherapy combined with surgery such as limb salvage or amputation, depending on the location and severity of the cancer. Limb salvage surgery aims to remove the tumor while preserving limb function through bone grafting or prosthetic reconstruction.

Uploaded by

Bakta Giri
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd

OSTEOSARCOMA

Kadek Gede Bakta Giri


DEFINITIONS

• A highly malignant tumor arising within the bone and


spreading rapidly outwards to the periosteum and
surrounding soft tissues.
• Mesenchymal malignancy (malignant spindle cells) that
differentiates to produce osteoid/immature bone.
INCIDENCE

• 2nd most common malignant bone tumor


• The 1,952 osteosarcomas accounted for 27.5% of all malignant
tumors and 19.2% of all bone tumors.
• Predominantly in children and adolescents
SEX AGE
• Approximately 58% of the • A few patients with
patients with osteosarcoma were osteosarcomas are in the first
male. decade of life.
• Peak incidence second decade
(44.7%).
LOCALIZATION

• The metaphyseal part of the long bones is the site of


predilection,
• Almost one-half of the osteosarcomas in the Mayo Clinic series
were in the region of the knee.
• Distal femur and proximal tibia.
ACCORDING TO AGE AND SEX OF THE
PATIENT AND SITE OF THE LESION
AGE DISTRIBUTION
SECONDARY OSTEOSARCOMA:

• Occurs in old people


• Associated with Paget’s disease or chronic
osteomyelitis
• Highly aggressive
DISTRIBUTION OF OSTEOSARCOMAS
IN PATIENTS 60 AND OLDER
SYMPTOMS

• Pain : may be intermittent


• Swelling (cardinal symptom)
• Pathological fracture
• Fever
• May can asymptomatic
PHYSICAL FINDINGS

• A painful mass on affected region


• Mass can very large
• Swelling
• May be associated with overlying prominent
veins
• Edema distal to the lesion
LABORATORY

• CBC
• ESR and CRP
• Lactate Dehydrogenase (LDH)
• Elevated Alkaline Phosphatase (ALP) may 2-3 times
IMAGING

• Radiographs
• sun-burst or hair on end pattern of matrix mineralization
• periosteal reaction (Codman's triangle)
• large soft tissue mass with maintenance of bone cortices

• MRI
• soft tissue involvement
• neurovascular involvement
• presence skip metastases

• Bone Scan
• very hot in osteosarcoma
• useful to evaluate extent of local disease and presence of bone
metastases

• CT Scan
• Chest CT scan for evaluate pulmonary metastase
BLASTIC AND DESTRUCTIVE
LESION (SUN-BURST)
CODMAN TRIANGLE
HISTOPATHOLOGY FEATURES

• Lichtenstein tersely stated the essential criteria as:


(1) the presence of a frankly sarcomatous stroma
(2) the direct formation of tumor osteoid and bone by this malignant
connective tissue.

• Osteosarcomas can be divided rather conveniently into


osteoblastic, chondroblastic, and fibroblastic groups.
• v
TREATMENT

Non Operative Operative


• Chemotherapy • Disarticulation
• Amputation
• Resection with
reconstruction/endoprosthesis
• Limb salvage surgery
• Resection of metastatic lesion
(lobectomy in lung)
CHEMOTHERAPY

• Doxorubicin
• Cisplatin
• Ifosfamide
• Methotrexate
• Cyclophosphamide
LIMB SALVAGE SURGERY

• Principle is to eradicate the bone tumor, retain integrity of


skeletal system and preserve the limb with useful function.
• After resection, skeletal reconstruction done by bone
grafting(auto or allograft) or by endoprosthesis (modular or
custom made).
• Prosthetic reconstruction is more effective
• As compared to the radical amputation and external prosthetic
fitting or limb sparing surgery with bone grafting this
treatment is more effective in early mobilization.
THANK YOU

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