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Osteosarcoma

Última revisión: 1 Feb 2026
Última actualización: 09 Sep 2025

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • childhood and adolescence
  • worsening pain over weeks to months
  • mass/swelling
  • male sex
Todos los datos

Otros factores de diagnóstico

  • race/ethnicity
  • tall stature
  • high birthweight
  • limp
  • history of trauma
  • limited range of motion
Todos los datos

Factores de riesgo

  • childhood and adolescence
  • Paget disease
  • radiation therapy
  • Rothmund-Thomson syndrome
  • familial retinoblastoma syndrome
  • Li-Fraumeni syndrome
  • race/ethnicity
  • nonfamilial deleterious germline variants
  • male sex
  • tall stature
  • high birthweight
  • chemotherapy exposure
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • conventional radiographs
  • bone biopsy
  • MRI
  • CT
  • CT thorax
  • bone scan
  • whole body fluorodeoxyglucose (FDG)-PET/CT
  • CBC
  • serum alkaline phosphatase
  • serum lactate dehydrogenase
Todos los datos

Algoritmo de tratamiento

Agudo

low-grade disease at presentation

high-grade nonmetastatic disease at presentation

metastatic disease at presentation

En curso

relapsed/refractory disease

Colaboradores

Autores

David Loeb, MD, PhD

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

Divulgaciones

DL declares that he has no competing interests.

Agradecimientos

Dr David Loeb would like to gratefully acknowledge Dr Luminita Rezeanu and Dr Michael J. Klein, the previous contributors to this topic.

Divulgaciones

LR and MJK declare that they have no competing interests.

Revisores por pares

Edward Sauter, MD, PhD

Professor of Surgery

Ellis Fischel Cancer Center

University of Missouri

Columbia

MO

Divulgaciones

ES declares that he has no competing interests.

Rachael Windsor, BSc, MBBS, MSc, MRCPCH

Locum Consultant Paediatric Oncologist

University College Hospital

London

UK

Disclosures

RW declares that she has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours: WHO classification of tumours. 5th ed. vol 3. Lyon, France: IARD Press; 2020

National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: bone cancer [internet publication].Full text

Strauss SJ, Frezza AM, Abecassis N, et al. Bone sarcomas: ESMO-EURACAN-GENTURIS-ERN PaedCan Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol. 2021 Dec;32(12):1520-36.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Osteosarcoma images
  • Differentials

    • Ewing sarcoma
    • Chondrosarcoma
    • Malignant fibrous histiocytoma
    More Differentials
  • Guidelines

    • NCCN clinical practice guidelines in oncology: bone cancer
    • ACR appropriateness criteria: suspected primary bone tumors
    More Guidelines
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