Osteosarcoma DR: Gehan mohamed

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OsteosarcomaDR 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