Osteosarcoma in children

Symptoms

There are various different symptoms. Osteosarcoma can produce a very solid bony substance (osteocondensing form) or it can infiltrate the bone and weaken it (osteolytic form).

In the first case, the patient may feel dull pain lasting several weeks before a mass is detected. This type may be discovered on an X-ray performed due to unexplained persistent pain.

In the second case, if the tumor is osteolytic, it weakens the bone and can cause a pathological fracture, which is a fracture following a minor fall which would not have damaged a healthy bone.

Diagnosis

A variety of tests and investigations are needed to identify:

• The exact nature of the disease through a biopsy.
• The location, which is identified by means of local examinations such as CT scan or magnetic resonance imaging (MRI).
• The potential spread of the disease which requires a PET scan examination and/or a bone marrow biospy/aspiration.

Other important examinations are also requested to ensure that the patient is able to tolerate treatment at the doses usually administered:

• Echocardiogram, ECG
• Kidney function test

Treatment

Chemotherapy is generally given before local treatment and continued afterwards to destroy any remaining cancer cells. Chemotherapy can reduce the size of the tumor before any surgical procedures are performed. It will be administered for a period of approximately 6 to 8 months.

Local treatment is surgical and aims for complete resection of the tumor. Large resections may require reconstruction using a prosthesis or a bone graft to enable optimal functional recovery.

Local treatments have significant orthopedic consequences. They require regular physiotherapy to ensure the best possible recovery of daily activities.