There is a considerable number of tumors formed from various tissues of our body. Thus, osteogenic sarcomas are formed from bone tissue. By definition, osteosarcoma is a malignant tumor-like formation of an aggressive nature that grows out of bone tissues.
A similar tumor has a primary origin, that is, it is initially formed in the bone itself, and is not a metastasis of another tumor. However, in oncological practice, isolated cases were noted, when osteosarcoma was the result of neglected and complex chronic osteomyelitis.
Osteosarcoma, as noted, is aggressive in nature, in other words, it is characterized by rapid development and metastasis in the early stages. Most often develops in tubular long bones.
Begins gradually with soreness, similar to rheumatism, but then swelling is formed, the nearest joint ceases to function normally, and the pain syndrome becomes unbearable. The tumor begins to metastasize. The main treatment is surgical removal in combination with chemotherapy.
Types of osteogenic sarcoma
There are several specific classifications of osteosarcoma. According to the growth pattern with respect to bone tissue, the tumor is divided into several varieties:
- Mixed osteosarcoma - when bone destruction and tumor growth are of an equivalent nature;
- Osteolytic osteosarcoma - when malignant lesions predominate in relation to bone tissue;
- Osteoplastic osteosarcoma - when the tumor grows its size.
In accordance with the growth pattern, the bony sarcoma has:
- Low grade of malignancy - small cell, osteoblastic, fibroplastic, chondroplastic formations;
- Intermediate grade of malignancy - periosteal neoplasms;
- High degree of malignancy - paraostal and intramedullary tumors.
In addition, osteosarcoma can carry:
- Metastatic character - when mutated cells spread through the body through the lymph flow and blood flow, forming additional foci of the tumor process in remote areas;
- Localized character - when a tumor hits a restricted area.
Rare forms of osteosarcoma
To rare formations of bone tissue are:
- Osteosarcoma of the pelvis - differs in poor prognostic data, because it spreads rapidly in all pelvic tissues;
- Small-cell osteogenic sarcoma - has a small-cell structure distinct from other tumors, usually developing in the femurs;
- Extraskeletal species osteosarcom - produces osteoids( a kind of bone cells) and bone tissue, localizes mainly in the lower extremities. The tumor is resistant to chemotherapeutic treatment, therefore it has a poor prognosis;
- Multifocal variety - multiple focal lesions in steric structures, prognosis fatal;
- Intraossal osteosarcoma - characterized by low malignancy, is easily detected and diagnosed. Can be benign, but sometimes recurs and increases malignancy;
- The periodic osteosarcoma - is localized on bone surfaces without penetrating into the bone marrow channel, contains soft tissue components;
- Parasal or juxtacortical - grows from the cortical bone surface, practically does not metastasize, develops slowly, does not penetrate the bone marrow, does not have soft tissue components. With neglect of the oncological process, it recurs and becomes malignant;
- Telangiectatic osteosarcoma - similar to giant cell or bone cystic aneurysmal type, develops similarly to the rest of the traditional varieties of osteosarcoma.
Localization of the disease
For osteosarcoma, the most common localization in long tubular bones. The frequency of the location of the tumor in various bone structures from the most common to rare locations:
- The most common osteosarcoma of the femur in the knee and thigh;
- On the tibia;
- Shoulder;
- Pelvic;
- Friable;
- On the shoulder girdle;
- The ulna.
The photo shows bone osteosarcoma
In rare cases, osteosarcoma is located on the mandibular bone, sacrum, foot, etc.
Stages of
As already noted, osteosarcoma can be metastatic when metastases spread to other organs, or localized when the tumor is localized in the original regiondefeat.
Several stages of the tumor process are distinguished:
- Stage I - Highly differentiated bone tumor, no metastases;
- Stage II - Low-differentiated tumor without metastasis;
- Stage III - multiple bone tumor;
- Stage IV - Development of regional and distant metastases beyond the differential dependence of education.
Causes of development of
The following factors predispose to the development of osteosarcoma:
- Traumatization of bone tissue , fractures, cracks capable of provoking a cell mutation;
- Radiation or radiation exposure;
- Inflammatory pathological processes of in bone tissues( osteomyelitis, etc.);
- Pathologies of precancerous nature like deforming osteitis or osteochondrosis;
- Malignant formations of other localization of provoke penetration of malignant cells into bone tissues, which leads to secondary osteosarcoma;
- Pediatric Retinoblastoma increases the likelihood of formation of osteosarcoma of cranial bones in the future;
- Hereditary pathologies like the syndrome of Lee-Fraumeni , which is accompanied by the presence of osteogenic sarcoma in combination with adrenal and breast cancer.
Symptoms and course of the disease
Osteogenic sarcoma is an extremely dangerous malignant tumor characterized by three main symptoms:
- Pain;
- Swelling;
- Disturbance of functions of the affected limb.
Tumor process is characterized by slow development. At first, the pain syndrome is of a slight, dull character , disturbing the patient only in the morning hours.
Soreness can be localized in the articular region, but there are no accumulations of fluid in the tissues. Over time, the pathological process involves nearby tissues, pain symptoms increase the intensity.
Bone begins to increase, there is a swelling of the tissues, a fine-meshed mesh appears on the skin. If osteosarcoma is localized in the legs, the pathological process causes pronounced lameness.
Osteosarcoma is rapidly growing, covering adjacent soft tissue structures, muscle tissue, bone marrow channel. With blood flow, cancer cells spread through the body at a crazy rate, creating metastases in other organs - the brain, lungs, lymph nodes, etc.
Metastasis
Statistically, about 15% of patients at the time of referral to a specialist have metastases.
Surgical treatment together with chemotherapeutic treatment provides long-term survival in a third of cancer patients.
Most often, osteosarcoma recurs with the spread of metastases to the lung tissue.
Clinical signs of a tumor in the jaw
The symptomatology of the mandibular osteosarcoma can not be manifested for a long time. There are three main symptoms:
- Pain - is located in the area of the teeth that are located near the formation;
- Tumor - it interferes with chewing, does not fully close the jaw, often causes swelling of the face;
- Loss of sensitivity of , numbness and tingling in the chin zone.
When the mandibular sarcoma begins to disintegrate, the patient rises intensively to 39-40 ° C.
Symptomatic manifestations of costal tumor
For osteosarcoma of the ribs, the following symptoms are typical:
- Minor soreness in the chest, often in combination with hyperthermia;
- There is a kind of swelling on the chest;
- Deep breathing causes pain syndrome;
- Pain at night becomes permanent;
- Ribs are limited in respiratory movements;
- The vascular network begins to appear on the sternum.
Diagnostic approach
The diagnostic process of osteosarcoma involves the following procedures:
- Computed tomography;
- Radiography;
- MRI.
With the help of such diagnostic techniques, it is possible to accurately determine the localization of the tumor process.
Treatment features
The therapeutic approach is based on the localization of education, its stage, relapses and other information. In general, the treatment of osteosarcoma is carried out in the following order:
- Before the operation, the patient undergoes a course of chemotherapy to reduce the underlying tumor and stop the growth of metastatic formations. Drugs like Methotrexate, Ifosfamide, Etoposide, Adryblastine and platinum-based drugs( Carboplatin or Cisplatin) are used;
- Operative treatment. At this stage, the tumor is removed surgically. The affected area of the bone is resected, and an implant is placed in its place. Amputation of the extremity is indicated for large tumor sizes. If the lesion spreads to the lymph nodes, then they are removed, as well as large metastases in the lungs, if any;
- After the surgical removal, a repeated course of chemotherapy is shown to finally destroy the malignant cell structures that may have remained after the operation.
Survival Forecast
If the sarcoma is localized and resectable, then a 5-year survival rate may be about 70%.If the tumor has started metastasis, the survival rate will be only 20-30%.If the tumor is formed in the extremities, then the prognosis is more optimistic than when the tumor is localized in the axial skeletal structures.
Video about osteosarcoma and its cause: