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Osteosarcoma - Never Disregard a Chronic Sprain in a Child

Osteosarcoma originates from bone-forming cells which are mesenchymal in origin. Osteosarcoma is a very common bone tumor and it is highly malignant. It is common among children and younger adults. The exact etiology causing osteosarcoma is idiopathic. One predisposing factor is rapid bone growth, especially during an adolescent growth spurt. Others include genetics, bone dysplasia and exposure to radiation. Osteosarcoma can occur in any bone. However, it commonly occurs in long bones near the metaphyseal growth plates. The femur bones are highly favored areas of invasion.

Osteosarcoma typically manifest in a chronic and insidious way. Symptoms can present months before the diagnosis of osteosarcoma. Commonly, the patient complains of pain associated with an activity. Sometimes, parent of the child mistake the pain as a sprain. As a result, the child may limp because of pain in the extremity. Swelling appears in some cases and may not appear in some cases. Uncommon symptoms are usually pathological fracture and systemic symptoms. The tumor commonly metastasizes to the lungs. The five-year survival rate for osteosarcoma is about 60% while some studies suggest that the initial size of the tumor correlates with histologic response to chemotherapy. The initial tumor size is now used as an important prognostic factor.

Typical investigations for osteosarcoma include a plain radiography, bone scan, computed tomography scan, magnetic resonance imaging and biopsy for histopathological examination of the tumor. Staging of the tumor is highly dependent on the structural location, histological grade and absence or presence of metastases. The best choice of treatment for this malignant cancer is surgical removal of the tumor. However, very often, limb-saving procedures can preserve limb function in those with osteosarcoma. In advanced stages of osteosarcoma, the choice of treatment usually involves chemotherapy. Physiotherapy and artificial limb training are often related topics post-surgical removal of osteosarcoma.

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