Osteosarcoma - bone

Osteosarcoma is a malignant neoplasm of bone. It is among the most common non hematologic primary malignant tumors of bone in both children and adults. The conventional type arises in the intramedullary cavity of the bone and represents 75 % of all osteosarcomas.These tumors penetrate and destroy the cortex of the bone and extend into surrounding soft tissues. In conventional intramedullary osteosarcoma , the predominant histologic pattern may be osteoblastic, fibroblastic, chondroblastic, giant cell rich, malignant fibrous histiocytoma like or partially telangiectatic.

Symptoms

The shin, thigh, and upper arm are common tumor sites in children and adolescents with osteosarcoma. It is in these areas that pain and swelling occur with the disease. Osteosarcoma can develop in other bones, but it is much less common.

Other symptoms are:

· Movement problems

· Fatigue and fever

· Stiff bones,

· Bone lumps and masses,

· Bone tenderness,

· Anemia, and

· Weight loss.

Causes

Medical research has identified a number of factors that may place a person at increased risk for bone cancer.

Age: Bone cancers are more common in children and young adults when bones grow rapidly.

Medical Disorders:

· Hereditary medical disorders:Very small number of cases having the cancer through hereditary

· Non-hereditary medical disorders: Adults that suffer from Paget's Disease and osteochondroma are at higher risk for developing osteosarcomas.

medical procedures and treatments done previously:

Radiotherapy and chemotherapy: Patients that had radiotherapy and chemotherapy for other forms of cancer have a higher risk for developing bone cancer. The risk for bone cancer increases when the patient was exposed to high doses of radiation therapy at younger ages.

Exposure to radioactive materials: Radioactive materials during the exposure, can build up in the bones and lead to cancerous cells to develop.

Medical Tests & Diagnosis

Anamnesis:This is the test done for detailed medical review of past health state

Laboratory Tests

· Alkaline phosphatase test

· PTH test

· Serum phosphorus

· Ionized calcium and serum calcium

Imaging Tests

Bone X-Ray: An x-ray test uses high energy electromagnetic radiation to penetrate the body & bones to create their image on a film. Dense tissues or structures appear white, the air black, and other structures in shades of gray

Computed tomography (CT) is a medical imaging method employing tomography created by computer processing. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation.

Magnetic resonance imaging (MRI):This is primarily a medical imaging technique used in radiology to visualize detailed internal structure and limited function of the body. MRI provides much greater contrast between the different soft tissues of the body than computed tomography (CT) does, making it especially useful in neurological (brain), musculoskeletal, cardiovascular, and oncological (cancer) imaging. Unlike CT, MRI uses no ionizing radiation

Biopsies: A biopsy is a medical procedure that removes a tissue sample for microscopic examination. The biopsy is the most conclusive test because it confirms if the tumor is malignant or benign, the bone cancer type (primary or secondary bone cancer), and stage.

Treatments

Radiation therapy: Radiation therapy (also called radiotherapy) is a type of local therapy. It affects cells only in the treated area. Radiation therapy is used alone for small tumors or for patients who cannot have surgery. It may be used before surgery to kill cancer cells and shrink the tumor. It also may be used after surgery to destroy cancer cells that may remain in the area.

There are two types of radiation therapy for Osteosarcoma

1. External-Beam Radiation Therapy: This is a common form of treatment used with bone cancer patients. It uses an external device called linear accelerator to generate high-energy rays that focuses on the targeted area. External beam radiation can be administrated before or after surgery.

2. Brachytherapy: This uses small radioactive pellets implanted into the affected area. This treatment can be administrated during surgery or after surgery . In both cases, when the treatment is completed, the catheters and radioactive seeds are removed.

Surgery: surgery is the primary treatment for bone cancer. Surgery is a medical procedure where the tumor and sometimes the surrounding bone tissue and muscles are removed. If the surgery is performed on the arm or leg bone, the surgeon tries to save the limb, or to replace the removed bone with bone tissue from other parts of the body or with an artificial prosthesis..

Computed tomography (CT): is a medical imaging method employing tomography created by computer processing. Digital geometry processing is used to generate a three-dimensional image of the inside of an object from a large series of two-dimensional X-ray images taken around a single axis of rotation.