Overview of Osteosarcoma

It is also known as osteogenic sarcoma

Malignancy:   Most common type of bone cancer.

Secondary growth can occur in the lungs (pulmonary) and is characterised by M2-like tumour-associated macrophages (TAMS) in the tumour stroma.

Stroma is the connective tissue that forms the basis of the cell or tissue.

Macrophages are a type of immune cell that kills disease-causing microbes and cancer cells by engulfing them.

Type of bone tumour: Primary

Grade: High

Location:

• Long bones:

Most frequent are the juxta-epiphyseal regions of long bones.

Other locations in the long bones:

Metaphysis of Legs (femur/thigh bone) – children

Metaphysis  of Arms (humerus)

• Sesamoid bones: knees
• Axial skeleton
• Irregular bones: Pelvis and Craniofacial bones

Onset:

Teenagers and young adults (3% of solid cancers)

Peak incidence at 16 years for girls and 18 years for boys

Children (4% of solid cancers)

First peak in children: 10 to 14 years

Adults – above 40 due to predisposed lesions and genetic conditions

Elderly (70s and 80s)

Risk Factors Of Osteosarcoma

Genetic Syndromes

Predisposed conditions like Paget’s disease

Gender

Ethnicity

References

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Cowan, P., Launico, M. and Kahai, P. (2024) Anatomy, Bones. Available at: https://www.ncbi.nlm.nih.gov/books/NBK537199/ (Accessed: 9^th April 2026)

Gerrand, C., Amary, F., Anwar, H.A., Brennan, B., Dileo, P., Kalkat, M.S., McCabe, M.G., McCullough, A.L., Parry, M.C., Patel, A., Seddon, B.M., Sherriff, J.M., Tirabosco, R. and Strauss, S.J. (2024). UK guidelines for the management of bone sarcomas. British Journal of Cancer. doi:https://doi.org/10.1038/s41416-024-02868-4.

Hosseini, H., Heydari, S., Kiavash Hushmandi, Salman Daneshi and Rasoul Raesi (2025). Bone tumors: a systematic review of prevalence, risk determinants, and survival patterns. BMC Cancer, 25(1). doi:https://doi.org/10.1186/s12885-025-13720-0.

Pullan, J.E., and Lotfollahzadeh, S. (2024) Primary Bone Cancer Available at: https://www.ncbi.nlm.nih.gov/books/NBK560830/ (Accessed: 9^th April 2026)

‌WHO Editorial Board. WHO classification of bone tumours. In WHO Classification of Tumours Editorial Board. Soft tissue and bone tumours. Bovee J, Flanagan AM, Lazar AJ, Nielsen GP and Yoshida A (eds) pp 338. International Agency for Research on Cancer (2020)

Updated July 2026 Next Review July 2028