Osteosarcoma Diagnosis and Characterization

Chapter 2

Abstract

1. Introduction

the sites of origin [1].

(Table 1) [3].

11

Differential Diagnosis of

of Osteosarcoma

Osteogenic Tumors in the Context

Mulazim Hussain Bukhari, Samina Qamar and Farwa Batool

Primary bone tumors are rare, but osteosarcoma (OS) is the fourth commonest non-hematological primary neoplasm of the bone in the adolescence, and the other three commonest neoplasms, in descending order, are leukemia, brain tumors, and lymphoma. The commonest presenting complaints are swelling and aches. These tumors cannot be diagnosed without the help of radiology. There is a wide age range of these neoplasms commonly appearing in the second and third decade of life with a peak incidence in early teens. Males are affected more than females. The exact cause of osteosarcoma is unknown. However, a number of risk factors, like genetic predisposition, some existing bone diseases, environmental risk factors, and radiations, have been identified. If the bone tumors are viewed by clinical, radiological, and histopathological perspectives, the correct diagnosis can be made easily. Chemotherapy combined with surgery is the standard treatment modality with better 5-year survival rates. Elevated AKP is an important prognostic factor in this malignancy.

Primary neoplasm of the bones is relatively uncommon. Among these tumors,

The nomenclature of bone tumors are described in "the World Health Organization (WHO)" classification system [2]. We are adopting a table from this classification to review the pathological diagnostic criteria of these lesions. A number of

The histological pictures of bone tumors alone are not enough to make a differentiation between osteosarcoma and benign tumors or other malignancies of the bone; therefore, radiological and clinical help is needed to make the final diagnosis of osteogenic sarcoma. Therefore, the chapter will not only address osteosarcoma

the osteosarcoma is the commonest primary malignant tumor, comprising of approximately 35% of all bone malignant tumors, followed by others like chondrosarcoma (25%), Ewing sarcoma (EWS) (16%), and chordomas (8%). This malignant tumor can arise from any bone, mainly usually in the metaphyseal (growth plates) long bones of the extremities, but the jaw, pelvis, and ribs may be

variants of osteosarcoma exist, including conventional types (osteoblastic, chondroblastic, fibroblastic, telangiectatic, multifocal, parosteal, and periosteal)

Keywords: aggressive osteoblastoma, osteogenic tumors, osteoma,

osteoid osteoma, osteoblastoma, osteogenic sarcoma

but will also discuss all osteogenic tumors stepwise [1].

## Chapter 2
