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Osteosarcoma
Etiology

Patients with mutations in the retinoblastoma gene have a several hundred fold greater incidence of osteosarcoma.
Pathogenesis

As with most malignancies, the precise pathogenesis is unclear.
The disease is associated with mutations in the retinoblastoma (Rb) gene, and deletions of or mutations in the p53 gene.
Other conditions that are associated with high bone turnover, such as Paget's disease and fibrous dysplasia of bone predispose to the development of osteosarcoma.
The tumor commonly arises during the time of maximal bone growth (late adolescence).,
Epidemiology

Most common primary malignant tumor of bone.
More commonly seen in men (about 2:1).
General Gross Description

Arise from the metaphysis of long bones.
Often big, bulky tumors.
Tan-white and gritty with areas of necrosis, hemorrhage and cystic degeneration.
The tumor frequently grows through the cortical bone and raises the periosteum.
The triangular space thus generated between the raised periosteum and the edge of the bone can be seen radiographically.
This triangle is often referred to as the Codman's triangle.
•Examples:
Osteosarcoma eroding through epiphysis Osteosarcoma involving epiphysis
General Microscopic Description

The histologic feature pathognomonic of osteosarcoma is the production of neoplastic osteoid matrix.
Tumor cells are osteocytes or osteoblasts and resemble normal osteoblasts. However, bizarre cells and atypia are invariably seen.
Other types of matrices, such as cartilage, are frequently seen.
•Examples:
High Power of Osteosarcoma High Power view of Osteosarcoma Low power view of an osteosarcoma Medium power view of an osteosarcoma
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 1234.

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Osteosarcoma
Synopsis by: T.V. Rajan M.D.Ph.D. (T1X500M91803)[333]
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