Podcast
Questions and Answers
Primary osteosarcomas typically occur in older adults aged 50 and above.
Primary osteosarcomas typically occur in older adults aged 50 and above.
False
Secondary osteosarcomas can arise from existing bone conditions like Paget disease and osteochondroma.
Secondary osteosarcomas can arise from existing bone conditions like Paget disease and osteochondroma.
True
Pain on movement and fever are typical clinical presentations of osteosarcoma.
Pain on movement and fever are typical clinical presentations of osteosarcoma.
True
The MRI scan is unnecessary for staging osteosarcoma.
The MRI scan is unnecessary for staging osteosarcoma.
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Parosteal osteosarcoma has a higher grade and typically affects younger children aged 5-10.
Parosteal osteosarcoma has a higher grade and typically affects younger children aged 5-10.
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Study Notes
Osteosarcoma Overview
- Osteosarcoma is a bone-forming tumor, either primary or secondary.
- Primary osteosarcomas occur in young patients or young adults, often around the knee joint (proximal tibia or distal femur).
- Secondary osteosarcomas develop from pre-existing bone lesions.
- Clinical presentation includes a painful mass, fever, and pain on movement.
- Elevated serum alkaline phosphatase (ALP) may be present in later stages.
- X-ray shows poorly defined, aggressive lesions with sunburst periosteal reaction and a fluffy cloud-like osseous matrix.
Secondary Osteosarcoma
- Secondary osteosarcomas arise from pre-existing bone conditions.
- Examples of pre-existing conditions include Paget disease, bone infarcts, osteochondromas, osteoblastomas, and radiotherapy changes.
Diagnosis and Staging
- Staging requires comprehensive imaging:
- MRI of the entire affected bone (checks for synchronous lesions)
- Nuclear medicine bone scan
- CT chest
- Biopsy should only occur at tertiary referral centers, where immediate tissue analysis with possible immediate amputation is possible to reduce the chance of seeding the biopsy tract.
Parosteal Osteosarcoma
- Characterized by a thin, stalk-like attachment to the underlying bone.
- Radiolucent plane may seem present, giving a "string sign" appearance, but a bone attachment exists.
Osteosarcoma Subtypes
- Parosteal: Lower grade, affecting older patients (20-50s)
- Telangiectatic: Lytic appearance, poor prognosis, fluid-fluid levels on imaging.
- Multicentric: Poor prognosis, occurring in children aged 5-10.
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Description
This quiz covers the essential aspects of osteosarcoma, including its types, presentation, and diagnostic methods. Learn about primary and secondary osteosarcomas, their symptoms, imaging techniques, and staging importance. Test your knowledge on this critical topic in oncology.
