Predisposing Factors of Osteosarcoma

Predisposing Factors of Osteosarcoma

Osteosarcoma can occur without any underlying cause, due to exposure to carcinogens, or in association with certain bone diseases or genetic disorders.

Osteosarcoma can arise de novo or in the presence of predisposing factors. The various predisposing factors to osteosarcoma are-

1. Radiation exposure

2. After Chemotherapy with alkylating agents.

3. Paget's disease- especially in those patients over the age of 40 years.

4. Preexisting bone lesions like fibrous dysplasia, osteochondromatosis

5. Foreign bodies- Tumours are seen at the site of orthopaedic implants.

6. Traumatic determinism- Trauma does not cause bone tumours but can call attention to an already present bone tumour.

7. Genetic predisposition

• Li Fraumeni Syndrome- usually due to a germline mutation of the TP53 gene
• Hereditary Retinoblastoma- caused by germline mutation of the RB1 gene
• Rothmund Thomas Syndrome
• Werner Syndrome
• Familial Paget Disease.

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.

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