An osteogenic sarcoma is a highly malignant tumor that almost always arises in the growing ends of long bones. This its incidence is virtually confined to growing teenagers, and the most common site is at the knee. The cause is unknown but there frequently is a history of some local injury preceding the onset, or at least the recognition, of the tumor .
Such a possible association with injury is in keeping with the increased incidence of this form of cancer in boys, and in particular athletic boys, as compared to girls.. The tumor forms a local painfully expanding swelling in the vicinity of a joint, and unless arrested is spread rapidly bu the bloodstream, principally to the lungs. Until recently the results of treatment were abysmal.
The choice lay between immediate amputation of the disease limb on diagnosis, and radiotherapy to the tumor and delayed amputation if no metastases were apparent within six months. Intensive chemotherapeutic regimes have now been developed that can improve this dismal situation, and in certain circumstances their skilled use combined with judicious radiotherapy to the primary tumor can permit the surgical removal of the tumor without the need for amputation.
Although such recent are encouraging, osteogenic sarcoma still remains one of the most vicious of all cancers and one of the most difficult to treat. Little evidence about the value of acerbate therapy for this kind of cancer is as yet available.
Ewing’s sarcoma is a confusing pathological entity, a comparatively rare rapidly expanding radio sensitive tumor of bone seen predominantly in children and young teenagers. Treatment is by local radiotherapy and systematic chemotherapy.
A chandroma is a benign tumor of cartilage, often arising in childhood, which continues to grow slowly throughout adult life and may attain a great size.
Synoviosarcomas are extremely rare malignant tumors arising from joint surfaces, usually involving knee. They can occur at any age after childhood and they metastasize to the lungs.
A myoma is a benign tumor of muscle tissue, the commonest site being in the uterus, the so called fibroid, frequently multiple. Malignant tumors of muscle origin are rather rare.
Fibrosarcomas are also rather rare tumors arising from fibroblasts of connective tissue, and they exhibit all grades of behaviour from the almost benign to the most malignant. They arise most commonly at sites of intense fibroblastic activity, as in old wounds, in scars, around chronic discharging sinuses, and not infrequently at the treated site many years after the overzealous use of radiotherapy for some other form of malignancy.
A lipoma is a very rare common slow growing quite benign tumor of the adipose cells, usually situated in the subcutaneous tissues. Lipomas are frequently multiple.
A spindle cell sarcome is a tumor so rapidly growing and so undifferentiated that its precise cell type of origin cannot be determined on microscopic examination. In this respect it resembles the anaplstic carcioma.
Lymphosarcomas and reticulum cell sarcomas are types of sarcoma very rare.