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Osteosarcoma

Diagnosis & Treatment of Osteosarcoma

Osteosarcoma is usually discovered because a person exhibits certain signs or symptoms, such as swelling or pain in a bone or joint, that prompts a visit to the doctor. If the doctor suspects a bone sarcoma after completing a medical history and performing a physical exam of the patient, other testing is required to confirm the diagnosis.


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This includes one or more of the following:

  • Imaging tests, including:
    • X-ray: An X-ray is a type of energy beam that can pass through the body and onto a film to make a picture of areas inside the body. X-rays will be taken of the chest and the area where the tumor is located.
    • EOS imaging: EOS imaging is a type of X-ray obtained by scanning a patient in either a standing or sitting position using a low dose of radiation; in children, EOS imaging simultaneously captures frontal and lateral full body images in just 15 seconds.
    • Magnetic resonance imaging (MRI) scan: This procedure uses a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body. Your child is not exposed to radiation during an MRI.
    • Computed tomography (CT) scan: This type of scan uses a combination of X-rays and computer technology to create cross-sectional images of bones or other parts of the body.
    • Bone scan: In this procedure, a very small amount of radioactive material is injected into a vein and travels through the bloodstream to collect in the bones affected by cancer. A scanner is used to detect the radioactive material.
    • Positron emission tomography (PET) scan: In this type of imaging, a radioactive sugar is injected into a vein. A scanner detects the radioactive material to make detailed, computerized pictures of areas of the body.
  • Biopsy: If the results of imaging tests strongly suggest that a patient has osteosarcoma or some other type of bone cancer, a biopsy (the removal of some of the tumor for viewing under a microscope and further testing) will be performed. Two main types of biopsies are used to diagnose suspected bone tumors:
    • Core needle biopsy: For this type of biopsy, the doctor uses a hollow needle to extract a small cylinder of tissue from the tumor. This procedure is typically performed with local anesthesia, where a numbing medicine is injected into the skin and other tissues at the biopsy site.
    • Surgical (open) biopsy: In an open biopsy, the physician – usually an orthopedic surgeon – cuts through the skin to expose the tumor and remove a small sample. Open biopsies are usually performed in an operating room with the patient under general anesthesia.
  • Lab tests: A pathologist tests the biopsy samples. If osteosarcoma is diagnosed, the pathologist will assign the tumor a grade, which is a measurement of how quickly the cancer is likely to grow and spread based on the appearance of the tumor cells.
  • Blood tests: Though not used to diagnose osteosarcoma, blood tests may be ordered once a diagnosis is made to help gauge the advancement of the osteosarcoma and to provide the doctor with a profile of a person’s overall health. Blood tests are also used to monitor a person’s health while they receive chemotherapy.

How is Osteosarcoma Treated?

If your child is diagnosed with osteosarcoma, his or her care team at UH Rainbow Babies & Children’s Angie Fowler Adolescent & Young Adult Cancer Center will discuss treatment options with you. It is you important to weigh the benefits of each option against possible risks and side effects.

Treatment options for osteosarcoma include surgery, chemotherapy, radiation therapy, Samarium, targeted therapy and immunotherapy:

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