Osteosarcoma is the most common type of malignant bone cancer, accounting for 35% of primary bone malignancies. There is a preference for the metaphyseal region of tubular long bones. 50% of cases occur around the knee. It is a malignant connective (soft) tissue tumor whose neoplastic cells present osteoblastic differentiation and form tumoral bone. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... // C00-D48 - Neoplasms (C00-C14) Malignant neoplasms, lip, oral cavity and pharynx (C00) Malignant neoplasm of lip (C01) Malignant neoplasm of base of tongue (C02) Malignant neoplasm of other and unspecified parts of tongue (C03) Malignant neoplasm of gum (C04) Malignant neoplasm of floor of mouth (C05) Malignant neoplasm of... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Disease Bold textDatabase is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A sarcoma is a cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. ... The metaphysis is the body of cartilage that separates the epiphyses and the diaphysis of long bones during growth. ... This article is about the skeletal organs. ... For other uses, see Knee (disambiguation). ... An osteoblast (from the Greek words for bone and germ or embryonic) is a mononucleate cell that is responsible for bone formation. ...

Prevalence

Terry Fox (1958-1981) began a run across Canada to raise money for cancer research. He developed osteogenic sarcoma as a teenager and had a leg amputated. Today the Terry Fox Run continues to raise money for cancer research. Through the money raised by the fundraising runs major improvements were made in the treatment of the cancer. Today amputations are rare.

Osteogenic Sarcoma is the 6th leading cancer in children under age 15. Osteogenic Sarcoma affects 400 children under age 20 and 500 adults (most between the ages of 15-30) every year in the USA. Approximately 1/3 of the 900 will die each year, or about 300 a year. A second peak in incidence occurs in the elderly, usually associated with an underlying bone pathology such as Paget's disease, medullary infarct, or prior irradiation. Although about 90% of patients are able to have limb-salvage surgery, complications, such as infection, prosthetic loosening and non-union, or local tumor recurrence may cause the need for further surgery or amputation. For the baseball player, see Terry Fox (baseball). ... Camp Julien, Afghanistan - Major-General Andrew Leslie leads Canadian troops through one of the many 2-km laps of the camp perimeter that make up the first Terry Fox Run ever held in Kabul. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Bold text X-ray of Pagets disease Pagets disease, otherwise known as osteitis deformans, is a chronic disorder that typically results in enlarged and deformed bones. ... Irradiation is the process by which an item is exposed to radiation. ...

Pathology

The tumor may be localized at the end of the long bones. Most often it affects the upper end of tibia or humerus, or lower end of femur. The tumor is solid, hard, irregular ("fir-tree" or "sun-burst" appearance on X-ray examination) due to the tumor spicules of calcified bone radiating in right angles. These right angles form what is known as Codman's triangle. Surrounding tissues are infiltrated. This article is about the vertebrate bone. ... The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ... Codmans triangle is a term used to describe the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone. ...

Microscopically: The characteric feature of osteosarcoma is presence of osteoid (bone formation) within the tumour. Tumor cells are very pleomorphic (anaplastic), some are giant, numerous atypical mitoses. These cells produce osteoid describing irregular trabeculae (amorphous, eosinophilic/pink) with or without central calcification (hematoxylinophilic/blue, granular) - tumor bone. Tumor cells are included in the osteoid matrix. Depending on the features of the tumour cells present (whether they resemble bone cells, cartilage cells or fibroblast cells), the tumour can be subclassified. 'Bold text This page is a candidate to be copied to Wiktionary. ... Categories: Move to Wiktionary | Stub ... Refers to cancer cells in the process of dividing. ... Osteoid is a protein mixture which is secreted by osteoblasts. ... A trabecula (plural trabeculae) is a small, often microscopic, tissue element in the form of a small beam, strut or rod, generally having a mechanical function, and usually but not necessarily composed of dense collagenous tissue. ... Eosinophilic is a technical term used by histologists. ... Haematoxylin is extracted from the wood of the logwood tree. ... Osteoid is a protein mixture which is secreted by osteoblasts. ...

Causes

The causes of osteosarcoma are not known. Questions remain about whether radium, or fluoride, in drinking water can act as "environmental triggers" for increasing the incidence of the disease. A low selenium or Vitamin D3 level or a high level of inflammation, as measured by interleukin-6, interleukin-8, or Nf-kB, Tumor Necrosis Factor Alpha may have a significant role as tumor suppressors and tumor initiators respectively. Recent studies show that an increased level of c-Fos can lead to osteosarcoma. The study that showed this result was done on transgenic mice in which the Fluid Sheer Stress (FSS) was increased to increase the number of osteoblast. Since c-Fos is ubiquitous in its overexpression it can not only increase the osteoblast resulting in the symptoms osteosarcoma. Therefore it is recently believed that a biological effect that may cause osteosarcoma is an error in the molecular pathway that controls c-Fos, causing an overexpression with no other counter stimuli to stop over production General Name, Symbol, Number radium, Ra, 88 Chemical series alkaline earth metals Group, Period, Block 2, 7, s Appearance silvery white metallic Standard atomic weight (226) g·mol−1 Electron configuration [Rn] 7s2 Electrons per shell 2, 8, 18, 32, 18, 8, 2 Physical properties Phase solid Density (near r. ... Fluoride is the ionic form of fluorine. ... This article is about the natural environment. ... For other uses, see Selenium (disambiguation). ... Vitamin D is a fat soluble vitamin that contributes to the maintenance of normal levels of calcium and phosphorus in the bloodstream. ... An abscess on the skin, showing the redness and swelling characteristic of inflammation. ...

Symptoms

Many patients first complain of pain that may be worse at night, and may have been occurring for some time. If the tumour is large, it can appear as a swelling. The affected bone is not as strong as normal bones and may fracture with minor trauma (a pathological fracture).

Diagnosis

Family physicians and orthopedists rarely see a malignant bone tumor (most bone tumors are benign). Thus, many patients are initially misdiagnosed with cysts or muscle problems, and some are sent straight to physical therapy without an x-ray. The word physician should not be confused with physicist, which means a scientist in the area of physics. ... In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ... Look up Benign in Wiktionary, the free dictionary. ... A cyst is a closed sac having a distinct membrane and developing abnormally in a cavity or structure of the body. ... Physical therapy (or physiotherapy[1]) is the provision of services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz...

The route to osteosarcoma diagnosis usually begins with an x-ray, continues with a combination of scans (CT scan, PET scan, bone scan, MRI) and ends with a surgical biopsy. Much can be seen on films, but the biopsy is the only definitive proof that a bone tumor is indeed malignant or benign. In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz... CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ... The mri are a fictional alien species in the Faded Sun Trilogy of C.J. Cherryh. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ... Look up Benign in Wiktionary, the free dictionary. ...

The biopsy of suspected osteosarcoma should be performed by a qualified orthopedic oncologist. The American Cancer Society states: "Probably in no other cancer is it as important to perform this procedure properly. An improperly performed biopsy may make it difficult to save the affected limb from amputation." Orthopedic surgery or orthopedics (BE: orthopaedics) is the branch of surgery concerned with acute, chronic, traumatic and recurrent injuries and other disorders of the locomotor system, its musclular and bone parts. ... Please refer to cancer for the biology of malignant disease, as well as a list of malignant diseases. ... The American Cancer Society (ACS) is a medical organization with a corporate attitude in the United States. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these to spread, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis (where cancer cells are transported through the bloodstream or lymphatic system). ... Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Partial hand amputation Amputation is the removal of a body extremity by trauma or surgery. ...

Treatment

Patients with osteosarcoma are best managed by a medical oncologist and an orthopedic oncologist experienced in managing sarcomas. Current standard treatment is to use neoadjuvant chemotherapy (chemotherapy given before surgery) followed by surgical resection. The percentage of tumor cell necrosis (cell death) seen in the tumor after surgery gives an idea of the prognosis and also lets the oncologist know if the chemotherapy regime should be altered after surgery. A sarcoma is a cancer of the bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. ... In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ... Chemotherapy is the use of chemical substances to treat disease. ... Chemotherapy is the use of chemical substances to treat disease. ... “Surgeon” redirects here. ... Necrosis (in Greek Νεκρός = Dead) is the name given to accidental death of cells and living tissue. ... Chemotherapy is the use of chemical substances to treat disease. ...

Standard therapy is a combination of limb-salvage orthopedic surgery and a combination of high dose methotrexate with leucovorin rescue, intra-arterial cisplatin caffeine, adriamycin, ifosfamide with mesna, BCD, etoposide, muramyl tri-peptite (MTP). This fracture of the lower cervical vertebrae, known as a teardrop fracture is one of the conditions treated by orthopaedic surgeons. ... Amethopterin redirects here. ... Folinic acid, generally administered as calcium folinate, is an adjuvant used in cancer chemotherapy involving the drug methotrexate. ... Cisplatin, cisplatinum or cis-diamminedichloroplatinum(II) (CDDP) is a platinum-based chemotherapy drug used to treat various types of cancers, including sarcomas, some carcinomas (e. ... Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... Doxorubicin or adriamycin is a DNA-interacting drug widely used in chemotherapy. ... Ifosfamide (Mitoxana®) Ifosfamide (pronounced i fos fa mide) is chemotherapy that is given as a treatment for many different types of cancer. ... Mesna (sodium 2-mercaptoethane sulfonate) is an adjuvant used in cancer chemotherapy involving cyclophosphamide and ifosfamide. ... This is a disambiguation page — a navigational aid which lists other pages that might otherwise share the same title. ... Etoposide phosphate (Eposin®, Etopophos®, Vepesid®, VP-16®) is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. ...

Ifosfamide can be used as an adjuvant treatment if the necrosis rate is low. Necrosis (in Greek Νεκρός = Dead) is the name given to accidental death of cells and living tissue. ...

3-year event free survival ranges from 50% to 75%. and 5-year survival ranges from 60% to 85+% in some studies. Overall, 60-65% treated 5-years ago (2000) will be alive today. Osteosarcoma has one of the lowest survival rates for pediatric cancer despite chemotherapy's success in osteosarcoma of 6 chemotherapies, interferon-alpha, interleukin-2, and being the prototype of solid tumors in cancer. To meet Wikipedias quality standards, this article or section may require cleanup. ... Interleukin-2 (IL2) is an interleukin, a type of biological response modifier that can improve the bodys natural response to disease. ...

Fluids are given for hydration. In chemistry, hydration is the condition of being combined with water. ...

Drugs like Kytril and Zofran help with nausea and vomiting. Granisetron is a serotonin 5-HT3 receptor antagonist used to treat nausea and vomiting following chemotherapy. ... Ondansetron is a 5-HT3 receptor antagonist principally used as an antiemetic. ... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ...

Neupogen, epogen, Neulasta help with white blood cell counts and neutrophil counts. Granulocyte-Colony Stimulating Factor (G-CSF) is a glycoprotein, growth factor or cytokine produced by a number of different tissues to stimulate the bone marrow to produce granulocytes. ... Epogen is the brand name of a form of Epoetin produced by the pharmaceutical company Amgen Inc. ... Granulocyte-Colony Stimulating Factor (G-CSF) is a glycoprotein, growth factor or cytokine produced by a number of different tissues to stimulate the bone marrow to produce granulocytes. ... White Blood Cells redirects here. ... Neutrophil granulocytes (commonly referred to as neutrophils) are a class of white blood cells and are part of the immune system. ...

Blood helps with anemia. This article discusses the medical condition. ...

Best treatment protocols

Top 5 treatment protocols are ranked here by osteosarcoma support

• 1. 97% 5-year survival Sept. 2005 Dr. Ross Wilkins, et al, Denver Clinic for Extremities at Risk, Denver, Colorado

• 2. 91 5-year survival 1999 Dr. Tsuchiya Kanazawa, Japan

• 3. 90 5-year survival 1999 Dr. Tsuchiya Kanazawa Japan

• 4. 78 5-year survival arm 4 March 2005 POG Pediatric Oncology Group

• 5. 76 5-year survival Jan. 1992 T10-Protocol MSKCC Dr. Meyers, Dr. Healey, Dr. Huvos, Dr. Rosen

Prognosis

• Prognosis is separated into three groups.

• Stage I osteosarcoma is rare and includes parosteal osteosarcoma or low-grade central osteosarcoma. It has an excellent prognosis (>90%) with wide resection.

• Stage IIb prognosis depends on the site of the tumor (proximal tibia, femur, pelvis, etc.) size of the tumor mass (in cm.), and the degree of necrosis from neoadjuvant chemotherapy (chemotherapy prior to surgery). Other pathological factors such as the degree of p-glycoprotein, whether the tumor is cxcr4-positive ^[1], or Her2-positive are also important, as these are associated with distant metastases to the lung. The prognosis for patients with metastatic osteosarcoma improves with longer times to metastases, (more than 12 months-24 months), a smaller number of metastases (and their resectability). It is better to have fewer metastases than longer time to metastases. Those with a longer length of time(>24months) and few nodules (2 or fewer) have the best prognosis with a 2-year survival after the metastases of 50% 5-year of 40% and 10 year 20%. If metastases are both local and regional, the prognosis is worse.

• Initial Presentation of stage III osteosarcoma with lung metastates depends on the resectability of the primary tumor and lung nodules, degree of necrosis of the primary tumor, and maybe the number of metastases. Overall prognosis is 30% or greater depending.

Canine Osteosarcoma

X-ray of osteosarcoma of the distal femur in a dog

Image File history File linksMetadata Size of this preview: 800 × 600 pixelsFull resolution (3072 × 2304 pixel, file size: 383 KB, MIME type: image/jpeg) File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... Image File history File linksMetadata Size of this preview: 800 × 600 pixelsFull resolution (3072 × 2304 pixel, file size: 383 KB, MIME type: image/jpeg) File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... In the NATO phonetic alphabet, X-ray represents the letter X. An X-ray picture (radiograph) taken by Röntgen An X-ray is a form of electromagnetic radiation with a wavelength approximately in the range of 5 pm to 10 nanometers (corresponding to frequencies in the range 30 PHz...

Risk factors

Osteosarcoma is the most common bone tumor in dogs and typically afflicts middle-age large and giant breed dogs such as Irish Wolfhounds, Greyhounds, German Shepherds, Rottweilers, and Great Danes. It has a ten times greater incidence in dogs than humans.^[2] A hereditary base has been shown in St. Bernard dogs.^[3] Spayed/neutered dogs have twice the risk of intact ones to develop osteosarcoma.^[4] Infestation with the parasite Spirocerca lupi can cause osteosarcoma of the esophagus.^[5] The Irish Wolfhound is a breed of dog (a sighthound) bred to hunt. ... This article is about the breed of dog. ... The German Shepherd Dog, also known as the Alsatian (in France and the UK), Schäfer (in other parts of Europe) and by the acronym GSD or simply German Shepherd, is a breed of dog originally bred for herding sheep. ... This article is about the dog breed. ... The Great Dane is a breed of dog known for its giant size and gentle personality. ... Incidence is a measure of the risk of developing some new condition within a specified period of time. ... See Heredity (disambiguation) for other meanings. ... Neutering, from the Latin neŭter (of neither type), is the removal of an animals reproductive organ, either all of it or a considerably large part of it. ... The esophagus (also spelled oesophagus/œsophagus, Greek ), or gullet is an organ in vertebrates which consists of a muscular tube through which food passes from the pharynx to the stomach. ...

Clinical presentation

The most commonly affected bones are the proximal humerus, the distal radius, the distal femur, and the tibia,^[6] following the basic premise "far from the elbow, close to the knee". Other sites include the ribs, the mandible, the spine, and the pelvis. Rarely, osteosarcoma may arise from soft-tissues (extraskeletal osteosarcoma). Metastasis of tumors involving the limb bones is very common, usually to the lungs. The tumor causes a great deal of pain, and can even lead to fracture of the affected bone. The humerus is a long bone in the arm or fore-legs (animals) that runs from the shoulder to the elbow. ... The radius is the bone of the forearm that extends from the outside of your limb to your phlangx (lateral) of the elbow to the thumb side of the wrist. ... The femur or thigh bone is the longest, most voluminous, and strongest bone of the mammalian bodies. ... This article is about the vertebrate bone. ... The mandible (from Latin mandibÅ­la, jawbone) or inferior maxillary bone is, together with the maxilla, the largest and strongest bone of the face. ... For the musical composition, see Metastasis (Xenakis composition). ...

Treatment and prognosis

Amputation of the leg is the initial treatment, although this alone will not prevent metastasis. Chemotherapy combined with amputation improves the survival time, but most dogs still die within a year.^[6] There are surgical techniques designed to save the leg (limb-sparing procedures), but they do not improve the prognosis. One key difference between osteosarcoma in dogs and humans is that the cancer is far more likely to spread to the lungs in dogs. Chemotherapy is the use of chemical substances to treat disease. ...

Some current studies indicate that osteoclast inhibitors such as alendronate and pamidronate may have beneficial effects on the quality of life by reducing osteolysis, thus reducing the degree of pain as well as the risk of pathological fractures.^[7] An osteoclast (from the Greek words for bone and broken) is a type of bone cell that removes bone tissue by removing the bones mineralized matrix. ...

Osteosarcoma in cats

Osteosarcoma is also the most common bone tumor in the cat, although not as frequently encountered, and most typically affects the rear legs. The cancer is less aggressive in cats than in dogs, and therefore amputation alone can lead to a significant survival time.^[6]

References

1. ^ http://www.osteosarcomasupport.org/cxcr4_metastases.pdf
2. ^ Withrow, S.J. (2003). Limb Sparing Trials and Canine Osteosarcoma. Genes, Dogs and Cancer: 3rd Annual Canine Cancer Conference, 2003. Retrieved on 2006-06-16.
3. ^ Bech-Nielsen, S., Haskins, M. E. et al. (1978). "Frequency of osteosarcoma among first-degree relatives of St. Bernard dogs". J Natl Cancer Inst 60(2):349-53.
4. ^ Ru, B., Terracini, G. et al. (1998). "Host related risk factors for canine osteosarcoma". Vet J 156(1):31-9.
5. ^ Ranen E, Lavy E et al. (2004). "Spirocercosis-associated esophageal sarcomas in dogs. A retrospective study of 17 cases (1997-2003)". Vet Parasitol 119(2-3):209-21.
6. ^ ^{a b c} Morrison, Wallace B. (1998). Cancer in Dogs and Cats, 1st ed., Williams and Wilkins. ISBN 0-683-06105-4. 
7. ^ Tomlin, J. L., Sturgeon, C. et al. (2000). "Use of the bisphosphonate drug alendronate for palliative management of osteosarcoma in two dogs". Vet Rec 147(5):129-32.

Year 2006 (MMVI) was a common year starting on Sunday of the Gregorian calendar. ... is the 167th day of the year (168th in leap years) in the Gregorian calendar. ...

External links

• Osteosarcoma: A Multidisciplinary Approach to Diagnosis and Treatment
• http://www.emedicine.com/PED/topic1684.htm
• http://www.mayoclinic.org/osteosarcoma/index.html
• Support Group and Information for people with osteosarcoma
• Treatment Information from U.S. National Cancer Institute
• Osteosarcoma by Peter Buecker, MD and Mark Gebhardt, MD
• Green Drakkoman Foundation to assist Warriors of Rare Childhood Cancers
• Osteosarcoma in Pets from Pet Cancer Center
• Superior Survival Seen with Osteosarcoma 2004

Media

• Promises in the Dark 1979 story of a young girl's osteosarcoma fight and its effect on her relationship with her boyfriend

• The Terry Fox Story 1983 movie about Terry Fox and his quest to raise $25 million for cancer research by running across Canada on his prosthetic leg.

• Fly With a Miracle. Sheila Belshaw tells the story of a family's journey through teenage osteosarcoma and its aftermath.