Characteristics of Osteosarcoma in Children

Osteosarcoma, a severe type of cancer that can spread to other areas of the body, particularly the lungs, isn't common in children. However, the prognosis significantly improves with early detection and subsequent treatment.
Characteristics of Osteosarcoma in Children

Last update: 07 September, 2021

Osteosarcoma accounts for 3% of cancers occurring in children. It’s also the most common type of bone cancer and one of the few that begin directly in the bone tissue. Unfortunately, it can spread to other regions of the body.

The survival rate of osteosarcoma in children is about 60 to 80% when it doesn’t spread beyond the initial tumor. Of course, it all depends on the effectiveness of the chemotherapy. In turn, the chances of survival are much lower if it’s already spread to other areas.

According to estimates, osteosarcoma represents approximately half of all cases of this disease in children. Most diagnoses occur between the ages of 10 and 30 years. In addition, it’s more common in adolescents.

What’s osteosarcoma?

A comparison of healthy and decayed bone.

This is a type of cancer that develops in bone cells. It’s also known as osteogenic sarcoma and manifests as a malignant tumor that can spread to almost any other part of the body — most often to the lungs first.

This cancer usually begins in the ends of the bones of the arms or legs, but also affects other bones. It usually grows in the following areas:

  • The top of the knee or distal femur
  • Below the knee or proximal tibia
  • Below the shoulder or proximal humerus

Osteosarcoma usually occurs in children older than 10 years of age. Some believe this cancer is due to DNA failure in bone cells during the stages of intense growth. In general, it affects boys more than girls and most cases occur in the knee.

Types of osteosarcoma in children

There are essentially two types of osteosarcoma in children and adults. Each of them includes several subtypes:

  • A central tumor, also known as a medullary tumor, appears deep in the bone
    • Conventional central osteosarcoma
    • Telangiectatic
    • Intraosseous, well-differentiated, or low-grade
    • Small cell osteosarcoma
  • A superficial, or peripheral, tumor that appears in the shallower areas
    • Parosteal osteosarcoma is also known as juxtacortical
    • Periosteal
    • Finally, high-grade superficial osteosarcoma

Risk factors

In general terms, osteosarcomas appear in people who neither have other diseases nor a family history of bone cancer. Everything indicates that a set of genetic changes that lead to the disease randomly arise.

Having said this, note that there are factors in some cases that promote the development of the disease. Among them:

  • History of radiation treatment for other types of cancer; especially at a young age
  • Inherited retinoblastoma
  • Previous diseases like Li-Fraumeni syndrome, Werner syndrome, and Rothmund-Thomson syndrome

Symptoms of osteosarcoma in children

An X-ray of a knee.

The symptoms of osteosarcoma vary. In fact, some patients are asymptomatic. However, some of the most common manifestations are:

  • Pain in a bone or joint, which increases with time until it becomes unbearable
  • Broken bones, without apparent cause
  • The presence of a mass or lump
  • The loss of bowel or bladder control.
  • Back pain

As you can imagine, it’s important to be attentive to the appearance of any of these symptoms, especially during adolescence. Don’t hesitate to consult a specialist if you suspect it in any way.

Diagnosis and treatment

The diagnosis is usually made on the basis of a clinical interview and health history, together with some tests. It usually starts with X-rays, which are complemented with an MRI. A doctor will order a biopsy as soon as they detect a problem and identify the area.

Then, after confirming the diagnosis, the physician will order a CT scan of the chest, a bone scan, and sometimes more MRI scans. All of this allows them to make a more precise diagnosis and determine a more effective treatment.

The treatment of osteosarcoma in children includes chemotherapy and aims to shrivel the cancerous mass. Afterward, surgery will be necessary to remove the tumors, and, finally, they’ll subject the patient to chemotherapy again so as to minimize the probability of recurring cancer.

Be on the lookout for symptoms of osteosarcoma in children

As you can see, osteosarcoma can appear subtly and without history in children. Moreover, parents must be attentive to the appearance of possible symptoms, especially during adolescence.

Finally, consult a specialist to rule out this and other possible pathologies that could seriously compromise health if you suspect your child might have his disease.

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