Osteosarcoma

DR: Gehan mohamed

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 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).

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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 variants
1. 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

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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

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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

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