Osteosarcoma

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Osteosarcoma

• Presented By Omar Ramirez

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What is Osteosarcoma?

• The most common primary malignant neoplasm of
  bone that occurs in children and young adults
• Accounts for 60 of malignant bone lesions in the
  first two decades of life

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Statistics

• On average, 400 cases are diagnosed per year.
• The overall survival rate for patients diagnosed
  between 1974 and 1994 is 63.
• Occurrence is slightly higher in
  African-Americans than in Whites and higher in
  males than in females.
• The highest occurrence in adolescence is 15 to 19
  years old.

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Causes

• The exact cause of Osteosarcoma is unknown,
  however, risk factors include
• Rapid Bone Growth appears to predispose persons
  to this disease. This most commonly occurs
  during the adolescent growth spurt in the
  metaphyseal area nearby the growth plate of long
  bones.
• Exposure to radiation is an environmental factor
  that causes a secondary form of Osteosarcoma.
• Abnormal development in bone tissue, such as
  Paget disease, are also risk factors that may be
  involved in genetic predisposition.

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Symptoms

• Pain and swelling of the affected area are the
  most common clinical findings
• On rare occasions, fever and night sweats may
  occur.

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Treatment

• Preoperative and/or postoperative chemotherapy
• Resection - A procedure performed for the
  specific purpose of removal
• Allograft replacement - the process of
  transplanting tissues and organs

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Medications

• Antineoplastic agents -- These agents disrupt DNA
  replication or cell division, thereby inhibiting
  tumor growth and promoting tumor cell death.
• Antiemetic agents Reduce the effects associated
  with chemotherapy

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Diagnostic Imaging

• MRI appearance (T1-weighted image) of
  Osteosarcoma of the proximal humerus. Note
  dramatic tumor extension into adjacent soft
  tissue regions.

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Diagnostic Imaging
Radiographic appearance (plain x-ray) of proximal
humeral Osteosarcoma.
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Prognosis

• The prognosis for patients diagnosed with
  Osteosarcoma depends primarily on whether
  metastases are detectable at diagnosis. Patients
  who present with metastases have a very poor
  prognosis, with long-term survival rates of less
  than 25.
• For patients with initially localized disease,
  the prognosis depends mainly on 2 variables
  resectability and response to chemotherapy. Those
  who have completely resectable disease and those
  whose tumors have an excellent histologic
  response to neoadjuvant chemotherapy have the
  best chance for cure.

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Future Directions

• Improving the survival rate and functional
  outcome and minimizing the short- and long-term
  side effects will continue to be a goal of
  clinical trials for Osteosarcoma. The major
  challenge, however, is curing patients with
  unresectable metastatic disease.

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Works Cited

• Pediatric Radiology The Requisites
• American Cancer Society (www.cancer.gov)
• http//www.emedicine.com