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Brunette Patient with Osteosarcoma looking into camera.

Osteosarcoma is a bone cancer that usually originates in the rapidly growing portion (metaphysis) of the long bones in the arms and legs. Characterized by an overproduction of abnormal bone-forming cells, the tumors often form near the knee (femur or tibia) or the upper arm bone near the shoulder (humerus). Less frequently, osteosarcoma develops in the jaw or pelvis.

Though relatively rare, osteosarcoma is the most common type of bone cancer. It primarily arises during periods of rapid growth and development, such as adolescence. Osteosarcoma is the most common bone cancer in younger patients. 

Osteosarcoma causes

Osteosarcoma occurs when healthy bone cells transform into cancerous cells. While the specific causes remain unclear, certain factors, such as a genetic predisposition or underlying medical condition, may contribute to this transformation.

Adolescents and young adults are most frequently affected by osteosarcoma, which suggests a potential link with the rapid bone growth that usually occurs during puberty. Most likely, a combination of genetic and environmental factors is a play.

Osteosarcoma risk factors

Some possible risk factors for osteosarcoma include:

  • Exposure to ionizing radiation from medical treatment or environmental sources
  • Certain noncancerous bone conditions, such as Paget’s disease and fibrous dysplasia
  • Certain inherited cancer syndromes, such as Bloom syndrome, hereditary retinoblastoma, Li-Fraumeni syndrome, Rothmund-Thomson syndrome II and Werner syndrome

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Osteosarcoma symptoms

In addition to interfering with healthy bone growth, osteosarcoma can destroy existing bone. Some possible symptoms include:

  • A noticeable lump or swelling along a bone
  • Occasional pain in a bone or near a joint that worsens and becomes more consistent as the tumor grows
  • Difficulty walking (if a leg bone is affected)
  • Loss of bladder or bowel control (if a pelvic bone is affected)
  • Difficulty with using arm for typical activities of daily living 

Osteosarcoma diagnostic testing

If osteosarcoma is suspected based on the symptoms, the physician will typically perform a thorough evaluation to rule out other possible causes, such as a benign tumor, bone infection (osteomyelitis) or another type of sarcoma. Typically, the diagnostic process begins with a discussion about the symptoms and a physical examination. The physician will feel for lumps and check for tenderness, pain, swelling and loss of joint motion.

Next, the physician may order traditional X-rays to visualize any areas of concern. If an abnormal mass is detected, the physician may order further imaging, such as a magnetic resonance imaging (MRI) scan, for more detailed visuals.

In addition to imaging, the physician may obtain a small sample of tumor tissue during an image-guided biopsy or open biopsy procedure. The sample will then be microscopically examined by a pathologist, who can identify cancerous cells and determine their type.

Together, the results of the physical exam, imaging tests and biopsy will help the physician better understand the tumor and determine its stage. This vital information can then be used to help guide treatment decisions.

Osteosarcoma treatment

Osteosarcoma treatment can vary based on the location, size and aggressiveness of the tumor, the extent of any cancer spread and the patient’s overall health. Surgical removal of the tumor is the preferred approach when possible.

A relatively small and nonaggressive osteosarcoma tumor can often be cured with surgery alone. In other cases, chemotherapy may be administered before the procedure to shrink the tumor and/or afterward to help prevent a recurrence. If surgery is not feasible or the entire tumor cannot be removed, radiation therapy may be used to control further cancer growth.

Frequently asked questions (FAQs) about osteosarcoma

The following FAQs-related articles provide additional information about osteosarcoma:

Benefit from world-class care at Moffitt Cancer Center

To ensure comprehensive osteosarcoma treatment, it is essential to seek care at a high-volume cancer center. The multispecialty team in Moffitt’s Sarcoma Program has extensive experience in diagnosing and treating all types of bone cancer, including osteosarcoma and other relatively rare conditions. Our orthopedic surgeons specialize in limb-preserving surgery, closely collaborating with our plastic surgeons to effectively remove the tumor, restore the affected tissues, promote full healing and preserve function.

Medically reviewed by Dr. Alexander Lazarides

You can request an appointment with a specialist in our Sarcoma Program by calling 1-888-663-3488  or submitting a new patient registration form online. We do not require referrals.