Osteosarcoma (OS) is a primary bone neoplasm, characterized by the uncontrolled proliferation of malignant mesenchymal cells capable of producing osteoid tissue. This condition represents a significant challenge in the health sector, mainly affecting children, adolescents and young adults, with a higher incidence in the second decade of life and predominance in males (Burger et al., 2018).
The etiology of OS is multifactorial, involving both genetic and environmental factors. In children, the disease generally appears without apparent risk factors, while in adults, it is often associated with pre-existing conditions, such as Paget’s disease, history of ionizing radiation and hereditary cancer predisposition syndromes (Burger et al., 2018).
Early diagnosis of OS is crucial for successful treatment and improving the patient’s prognosis. The clinical presentation includes progressive bone pain, increase in volume of the affected limb and limitation of movement, and pathological fracture may occur in some cases (Burger et al., 2018). The diagnostic investigation involves imaging tests, such as radiography, bone scintigraphy, computed tomography and magnetic resonance imaging, as well as biopsy for histological confirmation (Brasil, 2004).
The treatment of OS is multimodal, combining chemotherapy, surgery and, in some cases, radiotherapy. Neoadjuvant chemotherapy is administered before surgery to reduce the size of the tumor and increase the possibility of complete resection, while adjuvant chemotherapy is used after surgery to eliminate residual tumor cells and reduce the risk of metastases (Engel & Gava, 2012). Surgery can be performed with the aim of preserving the affected limb, whenever possible, or may involve amputation in more advanced cases (Brasil, 2004).
In summary, osteosarcoma is a complex malignant bone neoplasm, with significant challenges regarding early diagnosis, treatment and management of complications. Continuous advancement in research and development of new therapies is essential to improve the prognosis and quality of life of patients affected by this disease.
Reference :
ABNT: Brazil. Ministry of Health. Secretariat of Health Care. National Cancer Institute. Assistance Coordination. Initial approach to bone tumors / organized by Walter Mehoas. – Rio de Janeiro: INCA, 2004.
Nature: Burger, NB, Botelho, MP, Motta, IC, Dorneles, LME, & Serafini, OA (2018). Osteosarcoma: update. Average minutes p. 306-314. Porto Alegre.
Engel, EE, & Gava, NF (2012). Bone Tumors Principles of Diagnosis and Treatment – Introduction booklet to the topic. University of São Paulo Faculty of Medicine of Ribeirão Preto; Department of Biomechanics, Medicine and Rehabilitation of the Orthopedic Oncology Outpatient Locomotor Apparatus. Ribeirão Preto, March 2012.
