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Osteosarcoma is a malignant tumor of the bone. It often arises during the adolescent growth spurt, and presents first with persistent deep bone pain and possible swelling of the affected bone. The pain often awakens the child at night. Since they often arise in active adolescents, these tumors may initially be thought to be related to sports injury, especially since they may occur in proximity to a joint. For this reason, sports injuries that do not seem to heal as expected should be evaluated further to rule out more serious disease. Treatment is surgical, usually augmented by multi-drug chemotherapy.