Shaala Kirkby Ms. K. Burgan MBCS-AFT July 1, 2011 Osteosarcoma Osteosarcoma, per clinical characterization is considered the principal malignant bone tumor diagnosed in both preadolescent and adolescent children; osteosarcoma is indisputably the most prevalent variety of recognized bone cancers. Osteosarcoma manifests in the categorized diaphysis region of long-bones; the spinal column, cranium, and curved long-bones subsequently exhibit far less manifestation by way of osteosarcoma.

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Seldom; osteosarcoma can manifest in non-atypical regions of the body; including organs by way of dispersal via the conduit lymphatic vessels, these vessels contain a clear fluid identified as lymph; in rare exchanges, blood converted to interstitial fluid is contributory to the spread of cancer(s); manifestation by way of the aforementioned lymphoid system involving the pelvis, tendons, upper-body musculature, lungs and liver identified as secondary by the nature of spreading from one system to another.

Characteristically, osteosarcoma is a aggressively discriminant malignant tumor comprised of cancerous osseous tissue, classification of osteosarcoma is established by radiology, pathology and biopic connective tissue structure analysis; presently the origin of osteosarcoma remains elusive and symptomatic differential diagnosis is essential in determining the present of osteosarcoma and subsequent metastases at clinical onset.

Clinical onset; including but not limited to osteosarcoma’s origin, symptoms, treatment methodologies, prognosis and demographics There are very few, but highly painful symptoms associated with osteosarcoma; in correlation with (cite: http://www. kidshealth. org) previously mentioned are described as: “Persistent pain and swelling in an arm or a leg; especially near the knee or shoulder”.

As aforementioned, pain, typically manifests and therefore exhibits in the long-bones; the highly focused pain and subsequent sudden onset is rated severe, clinically nine out of ten (9/10) per the traditional physicians one (1) through ten (10) pain scale. “The experienced pain will awaken a child out of their sleep and may cause them to have an unexplained limp” as per (cite: http://www. stjudes. org). Contributory clinical symptoms include, but are not limited to the highly unanticipated fracturing of long-bones. In correlation with (cite: http://www. stjudes. rg): “If a tumor is present the bone becomes brittle and exceptionally easy to fracture”. Oncologists and orthopedic research imply such behavior is exhibited as the tumor infiltrates and therefore leads to bone demineralization; despite the a-typical proliferation, the origin of osteosarcoma remains elusive; researchers recently have suggested a genetic precursor; In correlation with (cite: http://www. wikipedia. org): “Questions still remain about whether radium, or fluoride, in drinking water can act as environmental triggers for increasing the incidence of the disease”.

Ostensibly, by citation; “persons who already have cancer or multiple cancer(s) present with osteosarcoma. Those who have a strong family history of cancer which is identified as familial cancer syndrome are prone to developing osteosarcoma” as conveyed by (cite: http://www. stjude. org). Furthermost by way clinical significance; “it is apparent that alterations in tumor suppressive genes and oncogene are fundamental in the production of osteosarcoma tumors, in most patients it is not clear which of these events occurs first, why it occurs or how it occurs” as presented by (cite: http://www. tjude. org). Treatment options for osteosarcoma are limited Forlorn individuals diagnosed with osteosarcoma, treatment modalities are limited to chemotherapy, radiation therapy, surgery and limb sparring. Majority of osteosarcoma diagnosis are located in the arm or leg; contingent upon tumor size and location, the limb can be sparred by surgical methods.

Chemotherapy is subsequently administered with the desired intent to reduce the spread of cancerous tissue and reduce the mass or masses; thereby controlling the spread of the disease and potentially reducing the physical size, accommodating the surgeon with far greater accuracy during removal; by definition, this combination of treatment modality is labeled neoadjuvant chemotherapy. In addition, chemotherapy is suggested after post-op as an ancillary measure to eradicate any remaining cancer; by definition, this modality is labeled adjuvant chemotherapy.

The highly evasive limb sparring technique includes but not limited to; autograft, a bone graft rendered from the patient’s harvested tissue, an Allograft is a bone graft harvested by way of a genetically compatible donor. Rotationplasty is a type of autograft performed by surgically removing a portion of limb, the remaining portion is subsequently rotated and re-attached; typically the ankle joint becomes the knee joint; if necessitated, fitment of a prosthetic ankle and foot is introduced, followed by physical rehabilitation.

Osteosarcoma is highly radiosensitive; therefore, radiation therapy is offered as a treatment modality. The highly focused X-ray emissions and/or alternate high-energy emissions eradicate cancer cells and/or diminish tumor density; given the nature of osteosarcoma, external beam radiotherapy (form of radiation therapy) is considered a standard method of treatment employed by oncologists. Statistics on Osteosarcoma: In the United States; nine-hundred (900) cases of osteosarcoma are diagnosed each and every year, approximately five-hundred (500) are adult cases older than twenty (20) years of age.

The other four-hundred (400) cases are preadolescent children and adolescents younger than twenty (20) years of age. As cited in Wikipedia™, the free encyclopedia online: “approximately one third (1/3) of the nine-hundred (900) will die each year, or about three-hundred (300) a year”. Clinical studies have recently revealed osteosarcoma is far more prevalent in males; the documented incidence for females is four and a half (4. 5) per million per year; worldwide. Osteosarcoma increases exponentially with age due to unregulated growth spurts; Osteosarcoma occurs between the ages ten (10) and thirty (30), per (cite: http://www. ancer. org). Instances of osteosarcoma rarely occur in preadolescent children younger than five (5) years of age; statistically adolescent teenagers are by far the most affected demographic with only a small percentage; ten percent (10%) or less, diagnosed with osteosarcoma in patients over the age of sixty (60). “Work Cited” 1). “Childhood Cancer: Osteosarcoma” – (2011) – The Nemours Foundation http://kidshealth. org/parent/medical/cancer/cancer_osteosarcoma. html#cat136 2). “Disease Information – Solid Tumor: Osteosarcoma” – (2008) – St.

Jude’s Children’s’ hospital http://www. stjude. org/stjude/v/index. jsp? vgnextoid=f87d4c2a71fca210VgnVCM1000001e0215acRCRD 3). “Osteosarcoma” – (2011) – Wikipedia, free encyclopedia http://en. wikipedia. org/wiki/Osteosarcoma 4). “Osteosarcoma”- all links – (2011) – American Cancer Society http://www. cancer. org/Search/index? QueryText=osteosarcoma&x=35&y=16 http://www. cancer. org/cancer/osteosarcoma/index http://www. cancer. org/Cancer/Osteosarcoma/DetailedGuide/osteosarcoma-new-research

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