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Sarcoma is a malignant tumor of non-epithelial origin. It develops from the mesenchyme (primary connective tissue). Sarcoma is fundamentally different from cancer, the genesis of which is always associated with epithelial cells.
General information about osteosarcoma
Malignant cells of osteosarcoma (osteosarcoma) originate from bone tissue. In some neoplasms of this type, fibroplastic elements dominate, while in others, chondroblastic ones.
According to radiological signs, osteosarcoma is divided into the following types:
osteolytic;
sclerotic (osteoplastic);
mixed.
This neoplasm is considered very malignant, since it arises from bone elements and is characterized by an active course. Osteosarcoma differs from many other neoplasms in its ability to metastasize very quickly.
This disease affects people of any age and gender. Most cases of osteosarcoma occur within 10-30 years. Most often, this neoplasm appears at the end of puberty. According to available statistics, men are 2 times more susceptible to it than women.
The main localization sites of osteosarcomas are noted in the following bones:
long tubular;
short and flat.
The bone tissue of the legs is affected 5-6 times more often than the upper limbs. About 80% of neoplasms of this type occur in the region of the knee joint. Often the tumor occurs on the tibia, fibula, pelvis, humerus, ulna. Often there are cases of the appearance of such neoplasms in the region of the shoulder girdle.
A typical place of occurrence of osteosarcoma is the metaepiphyseal end of long tubular bones. It also often occurs at an early age on the metaphysis of the bone. When the femur is affected, such a neoplasm most often affects the distal end. Almost 10% of all neoplasms of this type occur in the diaphysis.
Causes of osteosarcoma
This type of tumor most often occurs with very rapid bone growth. Most cases of such a neoplasm are noted in children of high stature, which does not correspond to age development. Osteosarcoma affects the growing parts of the human musculoskeletal system.
In some cases, osteogenic sarcoma is a consequence of an injury. That is why it is so important to take x-rays of the bones in time and diagnose the onset of the disease at an early stage.
One of the reasons for the appearance of this disease can be ionizing radiation, which children aged 12-16 are exposed to. Because of this, they may experience hormonal failure, which weakens the body of the child. The appearance of osteogenic sarcoma is also subject to those people who have such benign tumors as osteochondroma and enchodroma.
Symptoms of osteosarcoma
The onset of this disease is extremely difficult to pinpoint. With osteosarcoma, a symptom of the disease is severe night pain in the area of the affected bone, which is not stopped by any traditional analgesics. The first clinical symptom of sarcoma is the appearance of an enlarged tumor formation. As the tumor spreads and other neighboring tissues are involved in the pathogenic process, pain sensations increase more and more.
With the development of the disease, a distinct thickening of the metaphyseal section of the affected bone is detected. There is a pronounced pastosity of the tissues, and a clear venous network appears on the skin. As osteosarcoma progresses, the patient has contracture in the affected joint and lameness in the affected leg increases. The patient complains of sharp pain during palpation of the affected area of the bone.
With osteosarcoma, its rapid spread to neighboring tissues is noted. This neoplasm fills the bone marrow canal in a short period of time. In this case, the germination of the neoplasm in the muscle tissue occurs. Osteosarcoma early gives significant hematogenous metastases. They can spread to the lungs and brain.
Diagnosis of the disease
Osteogenic sarcoma can be easily diagnosed with a bone x-ray. At the initial stage of neoplasm development, osteoporosis of the affected bone is noted. The picture shows the blurring of the contours of the tumor. At the initial stage of the disease, it is characterized by the localization of the tumor in the metaphysis.
With the progression of osteosarcoma, a defect in the bone tissue is observed. Some tumors of this type are characterized by osteoblastic and proliferative processes, in which swelling of the exfoliated periosteum occurs. When osteosarcoma appears in children, needle periostitis is often noted, in which spicules (linear shadows of the bone) are formed.
An oncologist differentiates osteosarcoma from other neoplasms such as eosinophilic granuloma, chondrosarcoma, cartilage exostosis, osteoblastoma.
Treatment of osteogenic sarcoma
Treatment of osteosarcoma consists of the following stages:
Preoperative chemotherapy aimed at suppressing micrometastases in the lung tissue. Thanks to it, it is possible to achieve a reduction in the size of the tumor. During chemotherapy, the patient may be prescribed the following drugs: high-dose Methotrexate, Ifosfamide, Adriablastin, Etoposide, Carboplatin, Cisplatin.
Excision of the tumor, which often allows you to save most of the bone. Previously, doctors resorted to extensive surgery, during which the patient often had the limb affected by the tumor amputated. Modern methods of therapy allow for a gentle excision of the neoplasm, in which only part of the bone is removed. The removed area is replaced with a plastic or metal implant.
Postoperative chemotherapy, taking into account the results of preoperative chemotherapy.
In some particularly severe cases, when the neoplasm grows into the neurovascular bundle, a pathological fracture occurs, or the tumor is very large, doctors have to remove the affected limb. Modern methods of treatment allow preserving organs even in the presence of large metastases, for example, to the lungs. They are simply removed surgically. In cases where surgery is not possible for any reason, the patient may be prescribed radiation therapy.
The use of modern approaches to the treatment of osteosarcoma, including various types of chemotherapy and surgery, can achieve very good results. Due to this, the percentage of survival of patients with such a diagnosis only increases every year.