Signs and Symptoms of Osteosarcoma

Osteosarcomas can start on any bone, but most commonly affect the long bones of the arms or legs. Symptoms depend on where the tumor is, how large it is, and if it has spread to other parts of the body.

Signs or symptoms of the main tumor

The most common symptoms of an osteosarcoma tumor are:

• Pain: Bone or joint pain near the tumor is the most common symptom of osteosarcoma. These tumors often occur in the bones around the knee and shoulder in younger people, but they can occur in other bones as well. At first, the pain might come and go or be worse at night. The pain may be severe enough to keep you from sleeping. The pain often increases with activity and might result in a limp if the tumor is in a leg bone. Over time, the pain may become more intense or constant.
• Swelling: A swelling or lump you can see or feel at the site of the tumor is another common symptom. Although, this depends on where the tumor is located and may not happen until later.
• Fracture or broken bone: Osteosarcoma might weaken the bone it develops in, causing a fracture. Telangiectatic osteosarcomas, which tend to weaken bones more than other forms of osteosarcoma, are more likely to cause breaks where the tumor is. People with a fracture next to or through an osteosarcoma often describe a limb that was sore for a few months and suddenly became very painful when the fracture occurred.

Limb pain and swelling are common in normal, active children and teens. They are much more likely to be caused by normal bumps and bruises from sports or other activities, so they might not prompt a doctor visit right away. If your child has these symptoms and they do not go away within a few weeks (or they get worse), see a doctor.

These symptoms are less common in adults, so they should be a sign to see a doctor even sooner.

Signs or symptoms caused by cancer that has spread

About 1 in 5 people diagnosed with osteosarcoma have disease that has spread to other parts of the body when diagnosed, called metastatic disease. In most cases of osteosarcoma, these metastases do not cause symptoms. The most common place for osteosarcoma to spread is the lungs.

In advanced disease or osteosarcoma that recurs, spread to the lungs can cause:

• Cough
• Trouble breathing
• Chest pain
• Fluid buildup in the lungs

Osteosarcoma can also spread through the bones. About 1 in 20 people have other bone tumors that are smaller than the main tumor. These can be present in the same bone as the main tumor or in a different bone. Second tumors in the same bone or across a nearby joint are called skip lesions. These tumors can have no symptoms, or symptoms like the main tumor such as pain or swelling.