Osteosarcoma is the most common non-haematological primary malignant neoplasm of bone. Although it can occur at any age, it usually affects patients in the second and third decade of life with a peak incidence between 13 and 16 years of age. Cases beyond the third decade are rare and are almost exclusively composed of secondary osteosarcoma in patients with history of radiotherapy or Paget's disease. Although it is the most common primary malignancy of bone, overall osteosarcoma is an uncommon tumour. Reported incidences vary between 1 and 5 cases per million per year, with approximately 400 to 1000 new cases diagnosed every year in the US and comparable incidence in Europe.[3] The tumour has a slight predilection for males, with a reported male-to-female ratio of around 1.5:1 to 2:1. There is no apparent race or ethnic group preference. In the paediatric population, osteosarcoma represents only 5% of all malignant neoplasms.[2][4]

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