OsteosarcomaDR: Gehan mohamed
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04/19/23 2
Osteosarcoma
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Definition
Osteosarcoma is an aggressive malignant neoplasm arising from primitive transformed cells of mesenchymal origin (and thus a sarcoma) that exhibit osteoblastic differentiation and produce malignant osteoid.
It is the most common histological form of primary bone cancer in age 12-25yrs.
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Epidemiology
Male more than female
at any age but
75% of cases appear at age 12-25yrs
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Risk factors:
Radiation exposure
Patients who survive after taking therapy for another Cancer.
Retinoblastoma(malignant tumor arising from retina of eye).
Sites of predlection:
Osteosarcoma :It originates more frequently in the metaphyseal region of tubular long bones, with 42% occurring in the femur
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Skeletal distribution : most common at Knee region
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osteosarcoma
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Histopathologic variants1. Conventional: osteoblastic, chondroblastic, fibroblastic
2. Multifocal
3. Telangiectatic
4. Small cell
5. Intraosseous well-differentiated
6. Intracortical
7. Periosteal
8. Paraosteal
9. High-grade surface
10. Extraosseous
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Diagnosis of osteosarcoma
Clinical examiation
Radiologic examinatiom
Biopsy for histopathology
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Clinical Presentation
Painful mass arising from bone
Metastasize early
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Plain Xray
The area of tumor mass may be Lytic, sclerotic or mixed
In x – ray we can see Codman triangle
Codman triangle is a term used to describe the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone.
sun-burst" appearance on X-ray examination due to the tumor spicules of calcified bone radiating in right angles
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Codman triangle
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Codman triangle
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Local
CT
MRI
+/- Angiogram
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Systemic
Bone scan
CT Chest
Osteosarcoma : it is formed of Spindle shaped cells showing malignant criteria in form of pleomorphism,hyperchromasia, abnormal mitosis, giant cells . In
between spindle cells there is malignant osteoid.
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Differential Dx
Giant Cell Tumor
Aneursymal Bone Cyst
Ewings tumor
Osteoblastoma
Metastasis
Lymphoma