In osteosarcoma, one strives for removal in healthy tissue with a safety margin (tumor-free resection margins). The following form of surgical therapy is available: Wide resection – method of choice for malignant (malignant) bone tumors. Procedure: wide and radical resection (surgical removal) of the tumor with a safety margin of 5 cm (proximal (toward the … Osteosarcoma: Surgical Therapy
Osteosarcoma is not very sensitive to radiation. However, radiotherapy (radiation therapy) is used when osteosarcoma is inoperable or can be removed only marginally or intralesionally (see “Surgical Therapy”). Recommended techniques include intensity-modulated radiation therapy and proton therapy.
The clinical picture depends on the size or extent, location, and stage. The following symptoms and complaints may indicate osteosarcoma: Main symptoms Early bone pain that is load-dependent at onset but later occurs at rest and/or at night Local swelling, deformation at joints and bones (palpable) – swelling may be reddish or bluish in color … Osteosarcoma: Symptoms, Complaints, Signs
Pathogenesis (disease development) Osteosarcoma is one of the osseous tumors of bone. It arises from mesenchymal stem cells (mesenchyme = part of embryonic connective tissue) and can differentiate into various forms: bone-forming tumors (osteoblastic), cartilage-forming tumors (chondroblastic), connective tissue tumors (fibroblastic), and others. A characteristic feature of osteosarcoma is that its cells form osteoid (soft, … Osteosarcoma: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea). Aim for normal weight! … Osteosarcoma: Therapy Options
Infectious and parasitic diseases (A00-B99). Bone tuberculosis-2-3% of all tuberculosis cases involve the skeletal system, of which approximately 50-60% involve the spine; peak incidence: 40-60 years of age. Musculoskeletal system and connective tissue (M00-M99). Fibrodysplasia ossificans progressiva (FOP; synonyms: Fibrodysplasia ossificans multiplex progressiva, Myositis ossificans progressiva, Münchmeyer syndrome) – genetic disorder with autosomal dominant inheritance; … Osteosarcoma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that can be caused by osteosarcoma: Neoplasms – Tumor Diseases (C00-D48). Metastasis (daughter tumors) – esp. to the lungs, but also to the bones and liver. Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99). Chronic pain Injuries, poisonings, and other consequences of external … Osteosarcoma: Complications
Based on their histologic (fine tissue) characteristics, the WHO (World Health Organization) classifies osteosarcomas as follows: Classification Subtype Primary osteosarcoma Central (medullary) osteosarcoma Classic osteosarcoma Chondroblastic Fibroblastic Osteoblastic Teleangiectatic osteosarcoma Intraosseous well-differentiated osteosarcoma (low-grade) Small cell (mesenchymal) osteosarcoma Superficial (peripheral) osteosarcoma Parosseous (juxtacortical) well-differentiated osteosarcomas. Periosteal osteosarcomas, well to moderately differentiated High-grade osteosarcoma (conventional osteosarcoma) … Osteosarcoma: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin and mucous membranes Neck Extremities: [Swelling? may be reddish or bluish in color; size; consistency; displaceability of skin from underlying surface. Deformities of joints and … Osteosarcoma: Examination
1st order laboratory parameters – obligatory laboratory tests. Biopsy (tissue sample) – to determine the type of tumor as well as its aggressiveness; most important diagnostic measure in cases of suspected tumor; performed following imaging procedures (see “Medical Device Diagnostics“)Caveat: When performing this procedure, possible effects on the upcoming tumor resection and subsequent reconstruction must … Osteosarcoma: Test and Diagnosis
Therapeutic targets Relief of pain Stabilization of bone sections at risk of fracture Reduction of tumor size – preoperatively (before surgery) by chemotherapy (neoadjuvant chemotherapy). Removal of the tumor – see “Surgical therapy“. Healing Therapy recommendations Therapy depends on the extent of the bone tumor. Most often, therapy consists of a combination of surgery and … Osteosarcoma: Drug Therapy
Obligatory medical device diagnostics. Conventional radiography of the affected body region, in two planes – to assess the extent of tumor growth and, if necessary, skip metastases (nearby daughter tumors); that is, the entire affected bone and adjacent joint regions should be assessed Computed tomography (CT; sectional imaging procedure (X-ray images from different directions with … Osteosarcoma: Diagnostic Tests
