Diagnosis of Osteosarcoma & MFH

Diagnosis of Osteosarcoma & MFH

The following tests and procedures may be used to diagnose osteosarcoma and MFH:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • X-ray: An x-ray of the organs and bones inside the body. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • Biopsy: A biopsy is done to diagnose osteosarcoma. The type of biopsy that is done will be based on the size of the tumor and where it is in the body. There are three types of biopsy that may be used:
    • Fine-needle aspiration (FNA) biopsy: The removal of tissue or fluid using a thin needle.
    • Core biopsy: The removal of tissue using a wide needle.
    • Incisional biopsy: The removal of part of a lump or a sample of tissue that doesn’t look normal.
The following tests may be done on the tissue that is removed:
  • Light and electron microscopy: A laboratory test in which cells in a sample of tissue are viewed under regular and high-powered microscopes to look for certain changes in the cells.
  • Cytogenetic analysis: A laboratory test in which cells in a sample of tissue are viewed under a microscope to look for certain changes in the chromosomes.
  • Immunocytochemistry study: A laboratory test in which a substance such as an antibody, dye, or radioisotope is added to a sample of cancer cells to test for certain antigens. This type of study is used to tell the difference between different types of cancer.
 

Prognosis

The prognosis of untreated osteosarcoma and MFH depends on the following:
  • Where the tumor is in the body and whether tumors formed in more than one bone.
  • The size of the tumor.
  • Whether the cancer has spread to other parts of the body and where it has spread.
  • The age of the patient.
  • The type of tumor (based on how the cancer cells look under a microscope).
  • Whether the patient has certain genetic diseases.
After osteosarcoma or MFH is treated, prognosis also depends on the following:
  • How much of the cancer was killed by chemotherapy.
  • How much of the tumor was taken out by surgery.
  • Whether chemotherapy is delayed for more than 3 weeks after surgery takes place.
Treatment options for osteosarcoma and MFH depend on the following:
  • Where the tumor is in the body.
  • The size of the tumor.
  • The stage of the cancer.
  • Whether the bones are still growing.
  • The patient’s age and general health.
  • The desire of the patient and family for the patient to be able to participate in activities such as sports or have a certain appearance.
  • Whether the cancer is newly diagnosed or has recurred (come back) after treatment.
 

Stages of Osteosarcoma and Malignant Fibrous Histiocytoma of Bone

After osteosarcoma or malignant fibrous histiocytoma (MFH) has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body. The process used to find out if cancer has spread to other parts of the body is called staging, The following tests and procedures may be used:
  • X-ray
  • CT scan
  • MRI
  • Bone scan
  • PET scan
 

Metastasis

Cancer spreads in the body through tissue, lymph system or blood. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another tumor may form. This process is called metastasis. The secondary tumor is the same type of cancer as the primary tumor. Osteosarcoma and MFH are described as either localized or metastatic.
  • Localized osteosarcoma or MFH has not spread out of the bone where the cancer started.
  • There may be one or more areas of cancer in the bone that can be removed during surgery.
  • Metastatic osteosarcoma or MFH has spread from the bone in which the cancer began to other parts of the body. The cancer most often spreads to the lungs. It may also spread to other bones.
 

Recurrent Osteosarcoma and MFH

Recurrent osteosarcoma and malignant fibrous histiocytoma (MFH) of bone are cancers that have recurred (come back) after being treated. The cancer may come back in the bone or in other parts of the body. Osteosarcoma and MFH most often recur in the lung, bone, or both. When osteosarcoma recurs, it is usually within 18 months after treatment is completed.