What is Osteogenic Sarcoma?

Osteogenic sarcoma is a tumour, which starts in a bone. Osteogenic means bone forming. No one knows what causes osteogenic tumours, but we do know that they are not caused by injury. Most often they arise around the knee but can involve any bone in the body. Usually, older children and adolescents, develop these tumours.

Signs and symptoms

Pain in the bone is usually the only symptom that a child has when this tumour develops. Sometimes an obvious swelling occurs.

Diagnosis

If a child has pain in a bone an x-ray will probably be taken. If this suggests there is a tumour, an MRI scan will be performed to give an idea of the extent of the tumour and will be done prior to a biopsy, which is needed to confirm the diagnosis. A CT of the chest and a PET/MRI will be carried out to find if the cancer has spread to other parts of the body.  

Treatment

The exact surgical treatment for osteosarcoma varies depending on the age of the child and where the tumour is located. In general, chemotherapy is given first to kill the main tumour and any possible metastases while hopefully shrinking the tumour to enable surgery with the least morbidity. In almost all cases, the tumour is removed later by surgery. Surgical options for all patients will be discussed on an individual basis. For inoperable tumours, radiotherapy is used for local control. Outcomes for osteosarcoma in children are largely dependent on whether there is tumour spread outside the bone of origin, with favourable outcomes for localised disease and unfavourable outcomes for metastatic disease. 

Follow-up care

Routine surveillance after completion of treatment will usually include x-rays of the primary site, and a CT of the chest. After treatment has finished the child will also be seen at regular intervals to monitor growth and development. Treatment may affect the growth of the limb and regular follow up from the orthopaedic surgical team is frequently required.