Osteosarcoma is a malignant bone tumor. It is a type of sarcoma, which are cancerous tumors in the bone or soft tissues. Osteosarcoma is most common in teens and young adults, but osteosarcoma can occur at any age. In children and young adults, osteosarcoma usually develops in areas where the bone is growing quickly. Most tumors develop in the bones around the knee.

Osteosarcoma Symptoms and Diagnosis

People with osteosarcoma may not feel symptoms until the tumor grows to a large size and can be felt. However, when symptoms are present, they may include:

  • Pain in the affected area
  • Inflammation and swelling in the affected area
  • Inability to move limbs properly in the affected area
Sarcoma Diagnosis

If a lump or swelling indicate the possibility of osteosarcoma, doctors usually will suggest imaging tests:

If a bone tumor is found during imaging tests, doctors will perform a biopsy to determine whether it is a benign (non-cancerous) or malignant (cancerous) tumor. Biopsy can be done through either a needle or surgical incision.

  • Image-guided needle biopsy – Musculoskeletal radiology physicians, guided by CT or ultrasound, insert a needle into the tumor to take a small core sample of cells for analysis. A surgeon is also present to help guide the needle's path. This outpatient procedure uses a local anesthetic to numb the area.
  • Open biopsy – A surgeon uses a scalpel (surgical knife) to make a small incision and take a wedge of tumor for analysis. This is usually an outpatient procedure, but performed in the operating room with general anesthesia, so you are asleep.

Generally biopsy procedures are not carried out at the initial visit, but arranged for at a later date once all the information and imaging studies have been gathered.

Osteosarcoma Treatment

The type of osteosarcoma treatment you receive is based on whether the osteosarcoma is low or high grade, and whether the tumor is localized or metastasized. 

Low Grade Osteosarcoma 

Surgeons remove (or excise) the tumor. Our orthopedic oncology team is internationally recognized for expertise in limb-salvage reconstructive surgery when removing the tumor to avoid amputation, preserve appearance, and promote the greatest degree of mobility. Limb preservation is based on your age and health, and tumor size and location.

In limb-sparing surgery, once the tumor is removed, surgeons reconstruct any bone defects with bone graft, bone cement and/or metal replacements. They reconstruct any tissue defects usually with local tissue. Revolutionary advances in limb-sparing surgery (and in limb prostheses if amputation is the best course of treatment), help preserve mobility and function, and sustain a high quality of life. 

Localized High Grade Osteosarcoma 

If you have a localized (confined) high-grade (more aggressive) osteosarcoma, your treatment course is likely to include:

  • Chemotherapy before surgery
  • Limb-sparing surgery with metal bone and joint replacements, and allografts (donated bone graft), and reconstruction of soft tissue defects that may require muscle flaps, with assistance from a plastic surgeon
  • Additional chemotherapy after surgery, which may be the same or different from the chemotherapy you received before surgery
  • Physical therapy to restore range of motion and function to the affected limb
Metastatic Osteosarcoma 

Metastases are cancer cells that have spread from an original or primary site to one or more locations or organs elsewhere in the body. Metastatic osteosarcoma means your cancer has spread from a primary site (such as the tumor in your arm or leg) to another area, usually the lung or lymph nodes. If you are diagnosed with metastatic osteosarcoma, you will likely receive some combination of chemotherapy, radiation, and surgery, depending on the tumor and the areas of involvement.

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The Sarcoma Program in the Cancer Center at Beth Israel Deaconess Medical Center is internationally recognized for its team of experts, advanced treatment options, and personalized care.

Sarcoma Program