Osteosarcoma in the lower portion of the femur, note loss of bone structure & calcification in nearby muscle

Osteosarcoma

Osteosarcoma is the most common type of bone sarcoma in children and adolescents. It always presents with pain, although the symptoms are mild at the outset and often thought to be due to sports or other injuries. It is most common around the knee and shoulder.

Osteosarcoma is always treated with chemotherapy and surgery. Typically, chemotherapy is given both before and after surgery. Since surgery usually requires removal of a segment of bone and the adjacent joint, reconstruction requires an artificial joint replacement ("endoprosthesis"). In young children, this may need to be an expandable endoprosthesis in order to keep up with the growth of the other leg. Read more here.

 

Chondrosarcoma in pelvis, in addition to the bone destruction, there is calcification within the bone 

Chondrosarcoma

Chondrosarcoma is bone cancer that affects adults and seniors. It is more common around the pelvis & hips. Most patients experience pain that worsens gradually, over many months. Unlike other bone sarcomas, chondrosarcoma is not treated with chemotherapy, mostly because it is not as effective as with Ewing sarcoma and osteosarcoma. 

Chondrosarcoma is more likely to present as a low or intermediate grade tumor when compared to osteosarcoma and Ewing sarcoma, which most commonly present as high grade tumors.  Surgery is always required. When chondrosarcoma affects the portion of the pelvis that includes the hip joint, reconstruction can be challenging.

 

Ewing sarcoma in the lower portion of the femur

Ewing Sarcoma

Ewing sarcoma is a bone sarcoma that begins in the marrow space, mostly in children and adolescents. It does not always initially cause as much pain as osteosarcoma so the diagnosis is not made as quickly. Some patients may also have fevers, in addition to pain & swelling over the affected area. 

Similar to osteosarcoma, all patients undergo several months of chemotherapy, given before and after surgery to removed the affected portion of bone. Ewing sarcoma is most common in the lower extremities but can also occur in the pelvis, which is uncommon for osteosarcoma. In a few cases, such as large pelvis tumors deemed inadvisable for surgery, patients are treated with radiation instead.