Summary
Definition
The World Health Organization defines osteosarcoma as a primary osseous malignant neoplasm composed of mesenchymal cells producing osteoid and immature bone, even if only in small amounts.
[1]
[Figure caption and citation for the preceding image starts]:
Osteoblastic osteosarcoma of the distal femur (radiograph and photograph of the gross specimen)
Personal collections of Dr Michael J. Klein and Dr Luminita Rezeanu
[Citation ends].
History and exam
Key diagnostic factors
- childhood and adolescence
- worsening pain over weeks to months
- mass/swelling
Other diagnostic factors
- male sex
- limp
- history of trauma
- limited range of motion
- overlying skin ulceration
Risk factors
- childhood and adolescence
- Paget's disease
- radiotherapy
- Rothmund-Thomson syndrome
- familial retinoblastoma syndrome
- Li-Fraumeni syndrome
- fibrous dysplasia
- chemotherapy
- male sex
Diagnostic investigations
1st investigations to order
- conventional radiographs
- serum alkaline phosphatase
- serum lactate dehydrogenase
Investigations to consider
- CT primary tumour
- MRI primary tumour
- CT thorax
- radionuclide bone scan
- 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET-CT)
- bone biopsy
Treatment algorithm
Contributors
Authors VIEW ALL
Chief
Division of Pediatric Hematology, Oncology, and Marrow & Blood Cell Transplantation
Children's Hospital at Montefiore
Associate Professor, Pediatrics
Associate Professor, Developmental and Molecular Biology
Albert Einstein College of Medicine
Bronx
NY
Disclosures
DL declares that he has no competing interests.
Dr David Loeb would like to gratefully acknowledge Dr Luminita Rezeanu and Dr Michael J. Klein, the previous contributors to this topic. LR and MJK declare that they have no competing interests.
Peer reviewers VIEW ALL
Professor of Surgery
Ellis Fischel Cancer Center
University of Missouri
Columbia
MO
Disclosures
ES declares that he has no competing interests.
Locum Consultant Paediatric Oncologist
University College Hospital
London
UK
Disclosures
RW declares that she has no competing interests.
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