04 Femur: Osteosarcoma

05 Pathology specimen
Age/sex: 15-year-old male
Size: 16.9 x 11.5 x 5.5 cm
The specimen consists of the lower portion of the femur (the white line is the epiphyseal plate where two parts of the bone fuse in childhood). A well-demarcated tumor is present on the left side, replacing the bone and extending into the adjacent soft tissue (arrows). The individual died from metastatic disease within a year of amputation.


Osteosarcoma

Although osteosarcoma is the most common malignant bone tumor, it is still rare, occurring in only about 3 per million individuals in North America per year. It is characterized pathologically by the presence of osteoid, a mixture of collagen and amorphous connective tissue. Normally, osteoid becomes permeated by calcium to form mature bone. In osteosarcoma, the mineralization process is disturbed and the resulting “bone” is soft and prone to fracture.

The majority of tumors develop in growing long bones, and so are most often discovered around the knee or upper arm in children or adolescents. Pain is the most common symptom. Untreated, the tumor is fatal, most often because of metastases to the lungs. Treatment―usually a combination of surgery and chemotherapy―is associated with 5-year survival of about 50 to 60 %.

Terry Fox was diagnosed with osteosarcoma of the right leg in 1977. The night before his leg was amputated, he read a magazine article that inspired him to raise funds for cancer research. His Marathon of Hope began in St John’s Newfoundland in April 1980 and ended scarcely six months later in Thunder Bay when he was found to have metastatic cancer. He died the following year, his Marathon having raised more than $23 million. The Marathon has continued annually as the Terry Fox Run and had raised a remarkable $750 million by Jan 2018.

Below: A 1982 Canadian postage stamp commemorating Terry Fox’s Marathon of Hope.

Source: Canada Post. (1982). Terry Fox Marathon of Hope 915i. https://www.mcgill.ca/medicalmuseum/exhibits/canadian-health-care-stamps/health-care-builders/terry-fox

Canadian stamp Terry Fox

 

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