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Friday, March 28, 2008

Osteosarcoma: Teenage Nightmare

Friday, March 28, 2008


Osteosarcoma is the most widespread type of malignant bone cancer, accounting for 35% of principal bone malignancies. There is a partiality for the metaphyseal region of tubular elongated bones. 50% of cases transpire in the region of the knee. It is a malignant connective (soft) tissue growth whose neoplastic cells present osteoblastic delineation and outward appearance tumor bone.


Osteogenic Sarcoma is the 6th chief malignancy in children less than age 15. Osteogenic Sarcoma affects 400 children under age 20 and 500 adults each year in the USA. Just with reference to 1/3 of the 900 will pass away each year, or about 300 a year. A subsequent peak in frequency occurs in the elderly, usually allied with causal bone pathology such as Paget's disease, medullary infarct, or prior irradiation. Even though about 90% of patients are able to have limb-salvage surgery, tricky situations, such as infection, prosthetic loosening and non-union, or local tumor reappearance may cause the must for further surgery or amputation.


The cancer may be localized at the end of the elongated bones. Most frequently it affects the upper end of tibia or humerus, or lower end of femur. The tumor is unyielding, hard, irregular due to the tumor spicules of calcified bone radiating in right angles. These right angles form what is recognized as Codman's triangle. Adjoining tissues are permeated.


Under the microscope, the characteristic facet of osteosarcoma is presence of osteoid within the tumor. Cancer cells are very pleomorphic; some are giant, numerous out of character mitoses. These cells create osteoid describing asymmetrical trabeculae with or devoid of central calcification - tumor bone. Cancer cells are integrated in the osteoid matrix. Depending on the features of the cancer cells present, the tumor can be sub classified.


The causes of osteosarcoma are not known. Inquiries remain in relation to whether radium, or fluoride, in drinking water can act as "environmental triggers" for “greater than eve”r the incidence of the sickness. A small selenium or Vitamin D3 level or a high intensity of swelling, as measured by interleukin-6, interleukin-8, or Nf-kB, Tumor Necrosis Factor Alpha may have a considerable role as tumor suppressors and tumor initiators correspondingly. Latest studies confirm that an increased level of c-Fos can go ahead to osteosarcoma. The study that explains this outcome was done on transgenic mice in which the Fluid Sheer Stress (FSS) was increased to raise the number of osteoblast. Since c-Fos is omnipresent in it’s over appearance it can not only add to the osteoblast ensuing in the warning signs osteosarcoma. For that reason, it is freshly believed that a biological consequence that may cause osteosarcoma is an error in the molecular trail that controls c-Fos, causing an overexpression with no other counter stimuli to discontinue over production.

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