Related articles: Osteosarcoma
Definition
Osteosarcoma is a malignant tumor of the skeletal system. This neoplastic process is characterized by the synthesis of an immature and severely altered bone tissue, by malignant cells. The exact causes that cause its onset, however, are unknown.
Certain risk factors for osteosarcoma include exposure to radiation and abnormalities of particular tumor suppressor genes, implicated in the appearance of other types of cancer (eg p53 and RB1 mutations). Osteosarcoma is more frequent in pediatric age and among young adults aged between 10 and 20 years, especially male.
In some cases, osteosarcoma can originate from previous bone lesions, due for example to Paget's disease and fibrous dysplasia. The tumor can appear in any bone segment; long bones are most affected, especially around the knee.
Osteosarcoma has high malignancy, grows rapidly, tends to infiltrate the tissues and is able to metastate at a distance by blood, even in early stages, especially to the lungs or other bones.
Most common symptoms and signs *
- Anemia
- Asthenia
- Cachexia
- Intermittent claudication
- Coccyx pain
- Knee pain
- Bone pain
- Bone fractures
- Weight loss
- Bone Sclerosis
- Cold sensation
- Bone swelling
Further indications
The most common symptom of osteosarcoma is continuous and increasing pain in the bone affected by the tumor. Over time, localized swelling may develop, due to infiltration of nearby tissues by the rapidly growing tumor. The overlying skin may appear red, hot and with an evident network of dilated veins.
In advanced stages, osteosarcoma can weaken the structure of the affected bone, making it susceptible to pathological fractures. The dissemination of the tumor by blood can lead to the appearance of systemic symptoms: anemia, weight loss, fatigue and decay of the general conditions.
The diagnosis is based on the clinical evaluation of the patient and on diagnostic imaging tests (radiology, computed tomography, magnetic resonance and bone scintigraphy). Bone biopsy must always be performed to confirm the presence of a bone tumor. Laboratory tests always have high levels of alkaline phosphatases.
Currently, the therapeutic approach involves the combination of surgical excision and chemotherapy (before and after surgery). The treatment may possibly be associated with radiotherapy.
