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 (B)
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 (A)
Pain on movement and fever are typical clinical presentations of osteosarcoma.
Pain on movement and fever are typical clinical presentations of osteosarcoma.
True (A)
The MRI scan is unnecessary for staging osteosarcoma.
The MRI scan is unnecessary for staging osteosarcoma.
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.
Flashcards
Primary osteosarcoma
Primary osteosarcoma
A type of bone cancer that develops in young people, often near the knee joint, characterized by rapid growth and aggressive spread.
Secondary osteosarcoma
Secondary osteosarcoma
A type of bone cancer that arises from a pre-existing bone abnormality, such as Paget's disease or a bone infarct.
Parosteal osteosarcoma
Parosteal osteosarcoma
A subtype of osteosarcoma that grows along the surface of the bone, often with a stalk-like appearance.
Telangiectatic osteosarcoma
Telangiectatic osteosarcoma
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Multicentric Osteosarcoma
Multicentric Osteosarcoma
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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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