This is extremely important due to the limited margins available for surgical excision. It is characterized by abnormal growth of new bone cells leading to multiple bone deformities. The tumors usually arise in the pelvis, femur, or humerus. They typically are large and very destructive making surgery difficult. At the time of diagnosis, the cancer has often metastasized to the lungs.
Amputation is sometimes necessary.
Patients with suspected osteogenic sarcoma arising in Paget's disease should receive a bone scan and x-ray of all identified tumors. Additionally, a CT scan of the chest should be done to rule out metastases to the lungs. Treatment is the same as fully malignant osteogenic sarcoma arising in a younger population. Patients with preoperative chemotherapy, radical surgery of the tumor, followed by post-operative chemotherapy have the best prognosis. Tumors arising in the skull and spine are sometimes inoperable.