Presentation
Symptoms are usually present for several months before the diagnosis is made, with an average duration of approximately 3 months.
15-20% of patients with osteosarcoma present with radiographically detectable metastatic disease, but virtually all patients have sub clinical, microscopic metastases.
The most frequent site for metastatic presentation is the lung. Much less frequently, metastases at initial diagnosis occur in other bones and soft tissues.