Rare Cases of Cancer, Liposarcoma,Osteosarcoma


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Osteosarcoma, Liposarcoma -Rare Cases of Cancer:

Osteosarcoma, Liposarcoma -Rare Cases of Cancer V.MAHESH 11171R0043 Bharat Institute of Technology


Definition Cancer Rare Cancer Osteosarcoma Liposarcoma

Osteosarcoma :

Osteosarcoma Osteosarcoma is a type of cancer that produces immature bone. It is the type of cancer that arises in bones, and it is usually found at the end of long bones, often around the knee. Most people diagnosed with osteosarcoma are under the age of 25, and it is thought to occur more often in males than females.


Pathophysiology Once there is mutation of the DNA , it activates the oncogene which leads to a deactivation of the suppressor gene which causes a malignant osteoblast that leads to proliferation of abnormal osteoblasts . This causes formation of osteoid tissue . The osteoid tissue causes uncontrolled growth of the tumor in the bone and therefore overcrowding of the bone. There is then suppression of red bone marrow which leads to decreased production of  blood cells. A decrease in RBC leads to anemia while a decrease in WBC leads to a lowered infection resistance . The over crowding also causes pressure inside the bone which is a main cause of pain and fractures . The cancer then metastasizes spreading to other parts of the body especially the lungs , kidneys , CNS , liver and the spleen .




causes A s a result of radiation to an area of the body . Specific genetic changes and diseases


symptoms Most people with osteosarcoma do not feel sick . Patients may have a history of pain in the affected area and may have developed a limp. Often the pain is thought to be related to muscle soreness or "growing pains," but it does not go away with rest. Pathological fracture


diagnosis An MRI of the entire bone where the primary tumor is located A chest x-ray and CT scan of the chest to detect lung metastases A bone scan of the body to rule out distant spread of the disease A biopsy of the tumor, which provides a definite diagnosis based on the characteristics of tumor tissue seen under a microscope .


treatment Osteosarcoma is often treated with a combination of therapies that can include surgery, chemotherapy and radiation therapy. Most patients with high grade tumors receive about three months of chemotherapy, known as neo-adjuvant therapy, before surgery. An amputation or rotationplasty is the best way to completely remove the cancer and restore the patient to a functional life. Though radiation therapy is not widely used in osteosarcoma treatment, it can be effective and is occasionally recommended, especially when a tumor is difficult to remove surgically or when residual tumor cells remain after surgery.

Drugs used:

Drugs used Methotrexate Methotrexate is part of a general group of chemotherapy drugs known as anti-metabolites . It prevents cells from using folate to make DNA and RNA. Because cancer cells need these substances to make new cells, methotrexate helps to stop the growth of cancer cells . Doxorubicin Doxorubicin is part of a group of chemotherapy drugs known as anthracycline antibiotics. It slows or stops the growth of cancer cells


liposarcoma Liposarcoma is a rare cancer of connective tissues that resemble fat cells under a microscope . It accounts for up to 18% of all soft tissue sarcomas . Liposarcoma can occur in almost any part of the body, but more than half of liposarcoma cases involve the thigh, and up to a third involve the abdominal cavity.


types Well-differentiated liposarcoma Myxoid liposarcoma Pleomorphic liposarcoma Dedifferentiated liposarcoma



Histology of liposarcoma :

Histology of liposarcoma Well-differentiated liposarcoma shows features similar to lipoma , with a mixture of normal-appearing adipocytes intermixed with atypical adipocytes (figures 1 and 2). Pleomorphic liposarcoma may be may be difficult to recognize as being lipomatous in origin (figures 6, 7). These are composed of frankly atypical mesenchymal cells often with numerous mitoses andnecrosis . Dedifferentiated liposarcoma is defined as a well differentiated liposarcoma with dedifferentiation into a sarcoma with a different morphology. In these cases, finding the well-differentiated areas is critical for the diagnosis. Myxoid liposarcoma is a highly characteristic tumour composed of abundant mucin deposition and a plexiform capillary network


causes Scientists do not yet know the cause of liposarcoma . Although patients sometimes notice a tumor after they experience an injury, liposarcoma is not known to be caused by trauma. It is also not known to develop from benign lipomas, which are harmless lumps of fat.


symptoms Most people with liposarcoma do not feel sick . They might notice a lump (which can be soft or firm to the touch) that is usually painless and slow growing. Unfortunately , tumors in the abdomen can grow to be quite large before they are found.


treatment Surgery is the treatment for primary liposarcomas that have not yet spread to other organs. In most cases, a surgeon will remove the tumor, along with a wide margin of healthy tissue around the tumor, with the goal of leaving the area free of disease and preventing the tumor from returning . The combination of surgery and radiation therapy has been shown to prevent recurrence at the surgical site in about 85-90% of liposarcoma cases.

Drugs used:

Drugs used Vincristine Vincristine works by stopping the cancer cells from separating into two new cells. So it blocks the growth of the cancer . Etoposide Etoposide works by blocking an enzyme (called topoisomerase 2) which is necessary for cancer cells to divide and so grow into 2 new cells. If this enzyme is blocked, the cell's DNA gets tangled up and the cell cannot divide.


Reference Bacci G, Ferrari S, SangiorDamron TA.  Endoprosthetic replacement following limb-sparing resection for bone sarcoma.  Semin Surg Oncol 1997; 13:  3-10. Damron TA.  Endoprosthetic replacement following limb-sparing resection for bone sarcoma.  Semin Surg Oncol 1997; 13:  3-10. Arkun R, Memis A, Akalin T et al. Liposarcoma of soft tissue: MRI findings with pathologic correlation. Skeletal Radiology 1997; 26: pp 167-172. Arlen M, Higinbotham NL, Huvos AG et al. Radiation-induced sarcoma of bone. Cancer 1971; 28: 1087.

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