Question

Explore Osteosarcoma, in terms of etiology, diagnosis and treatment.

Answer 1

Osteosarcoma

It is a bone tumor and can occur in any bone of the body, but is the most common histological form of primary bone cancer.

Etiology:

• Familial history of the deletion of chromosome 13q14 that inactivates the retinoblastoma gene which is associated with osteosarcoma development.
• Rothmund–Thomson syndrome is associated with increased risk of this disease.
• Bone dysplasias, including Paget's disease of bone, fibrous dysplasia, enchondromatosis, and hereditary multiple exostoses, are also responsible for development of osteosarcoma.
• Li–Fraumeni syndrome (germline TP53 mutation) is a predisposing factor for osteosarcoma development.
• Large doses of Sr-90 emission from nuclear reactor increases the risk of bone cancer.

Diagnosis:

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.

Treatment: A complete radical, surgical, en bloc resection of the cancer, is the treatment of choice in osteosarcoma

Mifamurtide is used after bone tumor surgery to remove the tumor and together with chemotherapy to kill remaining cancer cells to reduce the risk of cancer recurrence.

Multi drug therapy as a combination of high-dose methotrexate with leucovorin rescue, intra-arterial cisplatin, adriamycin, ifosfamide with mesna, BCD (bleomycin, cyclophosphamide, dactinomycin), etoposide, and muramyl tripeptide.