Your SlideShare is downloading. ×
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply



Published on

1 Like
  • Be the first to comment

No Downloads
Total Views
On Slideshare
From Embeds
Number of Embeds
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

No notes for slide


  • 1.  Definition Introduction and brief history Epidemiology Etiology Pathology Classification
  • 2.  A mesenchymalmalignancy thatdifferentiates toproduce osteoid is anosteosarcoma nomatter how muchosteoid is produced OsteoidDeposition
  • 3.  Malignant tumor ofmesenchymal originhaving Spindle shapedcells that produce osteoid Second most commonprimary malignancy ofbone 15% of all biopsiedprimary bone tumors
  • 4.  In 1805, the French surgeon Alexis Boyer firstused the term "osteosarcoma’’ In 1847, the Baron Guillaume Dupuytren describedgross pathologic appearance of osteosarcoma Jaffe and Lichtenstein established histologiccriteria to diagnose common bone tumors
  • 5.  In the 1970s, Dr Norman Jaffe used variety ofeffective chemotherapeutic agents Dr William F. Enneking  introduced his surgicalstaging system for musculoskeletal sarcomas.
  • 6.  In the United States, the incidence ofosteosarcoma is 400 cases per year (4.8 permillion population <20 y).higher in blacks than in whiteshigher in males than in females The overall 5-year survival rate is 63%
  • 7.  Sites:Metaphysis: 90%Diaphysis: 8-10%- can occur in any boneLong Bones: 70%-80%Distal Femur (40%)Proximal Tibia (20%)Proximal Humerus(15%)Axial SkeletonPelvis
  • 8.  The exact cause of osteosarcoma is unknownRisk factors – Rapid bone growth Environmental Genetic Pre-existing benign /malignant lesions
  • 9.  Rapid bone growth- increased incidence during theadolescent growth spurt- location in the metaphyseal area adjacent to thegrowth plate (physis) of long bones GeneticLi-Fraumeni syndrome (p53 mutation)Rothmund-Thomson syndromeMutation of the RB gene (retinoblastoma)
  • 10.  EnvironmentalRadiation – localised radiation >2000 radslatent period -4 years to 40 yearsalpha rays>beta raysChemicals – methylcholanthreneacetylaminofluoreneberyllium compoundsVirus - RNA :mouse sarcoma virusDNA :polyoma ,SV 40 virus
  • 11.  Paget disease fibrous dysplasia enchondromatosis hereditary multipleexostoses chondrosarcoma
  • 12.  Gross appearanceSclerosing or osteolyticTypical featuresmetaphyseal locationvariable consistency andcoloursubperiosteal spreadperiosteum,epiphysis,cartilage act as barrier
  • 13. Gross appearance Greyish white colour Consistency variesfromSoft and gritty to hard Erodes inner cortex Invades subperiostealspace Penetrate periosteumand invades soft tissue
  • 14. Microscopic features Extensive irregularsheets of new osteoid Peripheral hypercellularstroma with anaplasticcells forming osteoid Central cells entrapedby osseous tissuebecome small androunded
  • 15. Gross appearance Very vascular tumour Consistency soft andfriable Necrotic andhemorrhagic cavitiesinterspersed withfibrous tissue Pathological fracturecommon
  • 16. Microscopic features Blood containingspaces withoutendothelial lining Sparse osseous tissue Spindle cells,anaplastic osteoblast,giant cells are seen
  • 17.  Anatomic location Degree of differentiation Multicentricity Etiology Histology
  • 18.  Intramedullary (75%) Juxtacortical/Surface (7--10%) Intracortical (.2%)
  • 19.  conventionalOsteoblasticChondroblasticFibroblasticSmall-cellEpithelioid Telangiectatic Well--differentiated
  • 20. Juxtacortical Osteosarcoma Parosteal Osteosarcoma Periosteal Osteosarcoma High Grade Surface Osteosarcoma
  • 21.  Origin: Arises fromouter layer ofperiosteum Usually a low gradetumor with fibroblasticstroma andosteoid/woven bone
  • 22.  Origin: Arises fromtheinner layer of theperiosteum Low to intermediategrade bone withpredominantchondroblasticdifferentiation
  • 23. Parosteal Osteosarcoma Periosteal Osteosarcoma
  • 24.  High Grade Surfaceosteosarcoma
  • 25.  Very rare High grade confined to the cortex Sites: Diaphysis offemur or tibia
  • 26.  Synchronous Osteosarcoma:Lesions that affect multiple bonesdiscovered within 6 months of each other Metachronous Osteosarcoma:Lesions involving multiple bonesdiscovered more than 6 months apart
  • 27.  Malignant transformation of benign conditionPaget diseasefibrous dysplasiabone infarct Arising in dedifferentiated chondrosarcoma
  • 28.  A mesenchymal malignancy that differentiates toproduce osteoid bone Second most common primary malignant tumor ofbone Site - metaphysis of long bone Age – adolescent (15 – 25 years)
  • 29.  Etiology not known Associated risk factors –rapid bone growth in youngpre-existing bone lesion in old age Most common - Conventional Osteosarcoma
  • 30. Thank you