Osteosarcoma

What is Osteosarcoma?
The most common primary malignant neoplasm of bone that occurs in children and young adults Accounts for 60% of malignant bone lesions in the first two decades of life

Statistics
On average, 400 cases are diagnosed per year. The overall survival rate for patients diagnosed between 1974 and 1994 is 63%. Occurrence is slightly higher in AfricanAmericans than in Whites and higher in males than in females. The highest occurrence in adolescence is 15 to 19 years old.

Causes
The exact cause of Osteosarcoma is unknown, however, risk factors include: Rapid Bone Growth appears to predispose persons to this disease. This most commonly occurs during the adolescent growth spurt in the metaphyseal area nearby the growth plate of long bones. Exposure to radiation is an environmental factor that causes a secondary form of Osteosarcoma. Abnormal development in bone tissue, such as Paget disease, are also risk factors that may be involved in genetic predisposition.

Symptoms
Pain and swelling of the affected area are the most common clinical findings On rare occasions, fever and night sweats may occur.

Treatment
Preoperative and/or postoperative chemotherapy Resection - A procedure performed for the specific purpose of removal Allograft replacement - the process of transplanting tissues and organs

Medications
Antineoplastic agents -- These agents disrupt DNA replication or cell division, thereby inhibiting tumor growth and promoting tumor cell death. Antiemetic agents Reduce the effects associated with chemotherapy

Diagnostic Imaging
MRI appearance (T1weighted image) of Osteosarcoma of the proximal humerus. Note dramatic tumor extension into adjacent soft tissue regions.

Diagnostic Imaging

Radiographic appearance (plain x-ray) of proximal humeral Osteosarcoma.

Prognosis
The prognosis for patients diagnosed with Osteosarcoma depends primarily on whether metastases are detectable at diagnosis. Patients who present with metastases have a very poor prognosis, with long-term survival rates of less than 25%. For patients with initially localized disease, the prognosis depends mainly on 2 variables: resectability and response to chemotherapy. Those who have completely resectable disease and those whose tumors have an excellent histologic response to neoadjuvant chemotherapy have the best chance for cure.

Future Directions
Improving the survival rate and functional outcome and minimizing the short- and longterm side effects will continue to be a goal of clinical trials for Osteosarcoma. The major challenge, however, is curing patients with unresectable metastatic disease.

Works Cited
Omar Ramirez : www.laredo.edu/science/rviswanath/BIOL2401P PT/.../Osteosarcoma.ppt Osteosarcoma. Presented By: Omar Ramirez. What is Osteosarcoma? The most common primary malignant neoplasm of bone that occurs in children and young ... Pediatric Radiology: The Requisites American Cancer Society (www.cancer.gov) http://www.emedicine.com