TumorsAdolescence
Osteosarcoma
The most common primary malignant bone tumor in children, typically arising in the metaphysis of long bones around the knee.
Presentation
- Progressive pain, often nocturnal, with palpable mass
- Pathologic fracture may occur
Imaging & Workup
- Radiographs show aggressive lesion, Codman triangle, sunburst pattern
- MRI of whole bone, chest CT and bone scan for staging
Treatment
Neoadjuvant chemo
Chemotherapy before and after surgery.
Limb-salvage resection
Wide resection with reconstruction when feasible.
Clinical Pearls
- Always biopsy through a planned resection corridor
- Refer to a specialist sarcoma center before biopsy