Diagnosis of Osteosarcoma

Diagnosis of Osteosarcoma

The diagnosis of an osteosarcoma is made with the collective information relating to the age of the patient, bone involved, radiological correlation and biopsy findings.

The following parameters help in the accurate diagnosis of osteosarcoma-

1. The age of the patient
2. The bone involved
3. X-ray and other imaging studies

4. Biopsy

After noting the age of the patient and site of the tumour, a plain radiograph or an X Ray of the whole affected bone is taken. Imaging should include the whole bone to look for satellite lesions within the tumour and spread beyond the tumor.

MRI (Magnetic Resource Imaging) of the whole affected area is also informative.

A CT Scan of the lungs helps in staging the tumour as osteosarcomas commonly metastasize or spread to the lungs.

A Bone scan may also be done.

Ultrasound Scan of the kidneys to rule out a primary kidney tumour is done when suspected.

Blood tests like-

• Complete Blood Counts,
• ESR or Erythrocyte Sedimentation Rate,
• Calcium levels,
• Alkaline phosphatise levels and
• Screening for multiple myeloma should be part of the diagnostic work up.

Once this is done, a biopsy of the tumour to study the microscopic appearance for the final diagnosis is done. Open biopsy or a needle biopsy can be done.

Ideally, image guided biopsies are preferred and biopsies should be performed at the centre responsible for further surgical management.

References:

1. Peter F.M.Choong. Bone Tumours. In Russell R.C.G, Williams N S, BulstrodeC.J.K editors. Bailey and Love s Short Practice of Surgery 24^th edition Arnold 2004:431
2. Rosenberg A E. Bones, Joints and Soft Tissue Tumours. In Kumar V, Abbas A K, Fausto N, Aster JC editors.Robbins and Cotran Pathologic Basis of Disease 8^th edition Elsevier 2011: 1205
3. Juan Rosai editor in Bone and Joints. In Rosai and Ackerman s Surgical Pathology 10^th edition Elsevier 2011: 2013
4. Raby N.Bone Tumours and other Local Conditions.In Hamblen DL, Simpson AHRW editors. Adam s Outline of Orthopaedics 14^th edition Elsevier 2010 : 104.