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The most common malignant tumor of bone. It arises from osteoblastic cells. Patients typically present with bone pain or a mass. The long bones are most commonly affected, and the tumor frequently metastasizes to other locations, especially the lung. Osteosarcoma is most common in males under 30 years of age. It can also occur secondary to medical conditions such as Paget disease and prior radiotherapy. Osteosarcoma is treated with chemotherapy and surgical excision of the primary tumor. With treatment, overall survival is approximately 60%-80%.


C41.9 – Malignant neoplasm of bone and articular cartilage, unspecified

21708004 – Osteosarcoma

Differential Diagnosis & Pitfalls

The differential for the initial presentation of pain is broad and includes stress fracture, arthritis, tenosynovitis, and any other painful musculoskeletal conditions.

Upon initial radiography, the lesion of osteosarcoma can still be similar to other primary bone cancers (eg, Ewing sarcoma), metastatic disease from other primary neoplasms, and noncancerous conditions such as benign tumors, osteomyelitis, or histiocytosis.

Also consider brown tumor, giant cell reparative granuloma, chondroblastoma, giant cell tumor of bone.

Best Tests

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Last Updated: 09/30/2016
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Osteosarcoma : Alkaline phosphatase elevated, Bone pain, Knee pain, Lytic bone lesions, Soft tissue swelling, Limb pain, ESR elevated
Imaging Studies image of Osteosarcoma
Coronal T1 MRI sequence demonstrates an infiltrative mass within the proximal tibial metaphysis with low T1 signal, periosteal reaction/breakthrough, and an associated soft tissue mass. These findings are compatible with an osteosarcoma.
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