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Expert-reviewed information summary about the treatment of osteosarcoma/malignant fibrous histiocytoma of bone.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.

A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Osteosarcoma

Osteogenic sarcoma

Last reviewed: October 30, 2013.

Osteosarcoma is a cancerous (malignant) bone tumor that usually develops in teenagers. It occurs when a teen is growing rapidly.

Causes

Osteosarcoma is the most common bone cancer in children. Average age at diagnosis is 15. Boys and girls are just as likely to get this tumor until the late teens, when it occurs more often in boys. Osteosarcoma is also common in people over age 60.

The cause is not known. In some cases, osteosarcoma runs in families. At least one gene has been linked to an increased risk. This gene is also associated with familial retinoblastoma. This is a cancer of the eye that occurs in children.

Osteosarcoma tends to occur in the bones of the:

  • Shin (near the knee)
  • Thigh (near the knee)
  • Upper arm (near the shoulder)

Osteosarcoma occurs most commonly in large bones in the area of bone with the fastest growth rate. However, it can occur in any bone.

Symptoms

  • Bone fracture (may occur after a routine movement)
  • Limitation of motion
  • Limping (if the tumor is in the leg)
  • Pain when lifting (if the tumor is in the arm)
  • Tenderness, swelling, or redness at the site of the tumor

Exams and Tests

Treatment

Treatment usually starts after a biopsy of the tumor is done.

Before surgery to remove the tumor, chemotherapy is usually given. This can shrink the tumor and make surgery easier. It may also kill any cancer cells that have spread to other parts of the body.

Surgery is used after chemotherapy to remove any remaining tumor. In most cases, surgery can remove the tumor while saving the affected limb. This is called limb-sparing surgery. In rare cases, more involved surgery (such as amputation) is necessary.

Support Groups

You can ease the stress of illness by joining a cancer support group. Sharing with others who have common experiences and problems can help you and your family not feel alone.

Outlook (Prognosis)

If the tumor has not spread to the lungs (pulmonary metastasis), long-term survival rates are better. If the cancer has spread to other parts of the body, the outlook is worse. However, there is still a chance of cure with effective treatment.

Possible Complications

  • Limb removal
  • Spread of cancer to the lungs
  • Side effects of chemotherapy

When to Contact a Medical Professional

Call your health care provider if you have persistent bone pain, tenderness, or swelling.

References

  1. Anderson ME, Randall RL, Springfield DS, Gebhardt MC. Sarcomas of bone. In: Niederhuber JE, Armitage JO, Doroshow JH, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2013:chap 92.
  2. National Cancer Institute. PDQ Osteosarcoma and malignant fibrous histiocytoma or bone treatment. Bethesda, Md: National Cancer Institute. Date last modified 5/23/2013. Available at: http://www.cancer.gov/cancertopics/pdq/treatment/osteosarcoma/HealthProfessional. Accessed November 8, 2013.
  3. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Bone Cancer. Version 1.2014. Available at: http://www.nccn.org/professionals/physician_glspdf/bone.pdf. Accessed November 8, 2013.

Review Date: 10/30/2013.

Reviewed by: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Methotrexate for high‐grade osteosarcoma in children and young adultsMethotrexate for high‐grade osteosarcoma in children and young adults
    As a result of the introduction of chemotherapy, the survival of children with osteosarcoma has improved dramatically. The majority of the currently used treatment protocols are based on a combination of doxorubicin, cisplatin, methotrexate (MTX) and/or ifosfamide, of which MTX seems to be one of the most active drugs. However, in the literature, this has not been unambiguously proven. A well‐informed decision on the use of MTX in the treatment of children and young adults diagnosed with primary high‐grade osteosarcoma should be based on high quality evidence on both antitumour effects and adverse effects.
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Figures

  • X-ray.
    Osteogenic sarcoma - x-ray.
    Ewings sarcoma - x-ray.
    Bone tumor.

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