Bone tumors are tumors that occur in various tissues of the skeletal system such as bone, cartilage, fibrous tissue, and fatty tissue. There are also benign and malignant bone tumors. Benign tumors may only bring about pain or fractures, while malignant tumors may be life-threatening. The most common benign bone tumors in China are osteochondroma, giant cell tumor of bone and chondrosarcoma, while the top three malignant bone tumors are metastatic bone tumor, osteosarcoma and chondrosarcoma. Early detection of bone tumors has a great impact on the diagnosis and treatment of doctors and the prognosis of patients, so it is very important to be familiar with the common symptoms of bone tumors for early detection and timely consultation. Pain in bones or joints (including pain in the spine), bony masses, and limb dysfunction are considered to be the three main signs of bone tumors, especially malignant bone tumors. Also noteworthy are skin and local vascular signs. Malignant tumors often have abundant blood vessels, skin color may change significantly, skin may be warm, and superficial veins may become angry. In order to detect malignant bone tumor in early stage, we should pay special attention to the following cases and do further examination: 1. When adolescents suddenly have unexplained pain around the knee joint with progressive aggravation. 2. 2. When adolescents develop acute osteomyelitis such as fever, limb pain, swelling and leukocytosis, they should be alert to the possibility of Ewing’s sarcoma and osteosarcoma. 3, Multiple endophytic chondrosarcomas, multiple osteochondrosarcomas and long tubular solitary osteochondrosarcomas are prone to malignant transformation into chondrosarcoma, and should be reviewed regularly to prevent malignant transformation when there are the above mentioned lesions. 4. If the elderly people have unexplained limb pain and low back pain, and there is a tendency of progressive aggravation, they should be alert to the possibility of metastatic bone tumor. Osteosarcoma patients are mostly young people, about 75% of the total number of cases. The main early symptom is pain, which may occur before the appearance of tumor, initially as intermittent pain, gradually turning into continuous severe pain, especially at night. In large malignant tumors, the pain occurs earlier and is more severe, and there is often a history of local trauma. The tumor at the end of the bone near the joint is large, with variable hardness, pressure pain, high local temperature, dilated veins, sometimes palpable pulsation, and pathological fracture may be present. Systemic health gradually declines to failure, and most patients have pulmonary metastases within a year. Since bone and soft tissue sarcoma is not known to the general public like lung cancer and liver cancer, the onset is more insidious and not easily detected, many patients and parents of children lack knowledge of sarcoma science and prevention, or mistake it for growing pains, resulting in often missing the disease. Once the best time is missed, patients often have to face the physical and mental pain caused by larger surgery or even amputation. Early detection is crucial to removing the lesion and preserving the limb. The diagnosis of osteosarcoma is not difficult. Experienced physicians can make the correct diagnosis in 70% of patients through clinical presentation and X-ray examination. The possibility of osteosarcoma should be especially thought of when young people have symptoms such as pain and swelling of the bone ends near the knee joint. And if the doctor is inexperienced, it is often easy to miss or misdiagnose the disease in its early stages. Before the 1970s, the treatment of osteosarcoma was mainly surgical amputation, but the efficacy was not satisfactory, and the 5-year survival rate was only 10%-20%. After the 1990s, people adopted neoadjuvant therapy, i.e. chemotherapy + surgery + chemotherapy, which reduced the amputation rate from 15% to 5%, and the disability rate was significantly reduced, and the 5-year survival rate reached 60-70%, and the survival time of patients was significantly extended. The treatment of malignant bone tumors is the most important part. The treatment of malignant bone tumor is a comprehensive treatment mainly based on surgery, supplemented by radiotherapy, chemotherapy and immunotherapy. The principle of treatment is to maintain the normal structure of bones and joints, preserve the function of limbs (limb preservation), and minimize the impact on the quality of life of patients on the basis of saving their lives. The combined application of chemotherapy (especially neoadjuvant chemotherapy) and radiation provides an important guarantee for bone tumor surgery. The main purpose of limb preservation treatment for bone tumors is to completely remove the tumor and preserve the function of the limb to improve the quality of life of patients. After more than 20 years of clinical research and practice, with the improvement of diagnostic imaging technology, pathological diagnosis technology, surgical technology and post-surgical rehabilitation therapy, limb preservation surgery has become the main development direction of malignant bone tumor treatment based on chemotherapy, according to the patient’s age, tumor nature, location, surgical stage, prognosis and the degree of required surgery. Compared with amputation, limb preservation preserves the appearance of the patient’s limb on the one hand, and preserves the function of the affected limb to a greater extent on the other hand, reducing the social and psychological impact of the surgery on the patient. In terms of long-term outcome comparison, a retrospective study of osteosarcoma showed that there is no statistical difference in tumor-free survival and overall survival between amputation and limb preservation patients if the surgery does achieve extensive surgical boundaries. Although limb-preserving treatment has become the mainstream direction of limb malignancy treatment, certain conditions are required for limb-preserving treatment: 1. the tumor does not invade important blood vessels and nerves; 2. the tumor can be completely removed outside the tumor to obtain a good surgical border; 3. the local recurrence rate after limb-preserving surgery should not be higher than that of amputation; 4. the local soft tissue condition is still acceptable and the preserved limb function is expected to be better than that of prosthesis. For those who are diagnosed late, whose tumor has invaded widely or recurred after limb preservation surgery and cannot take limb preservation surgery, or whose limbs have no function due to tumor, amputation is still a proven treatment method. However, with the development of medical technology in recent years, the scope of limb-sparing surgery has been further expanded. For example, in the past, nerve and vascular involvement was considered a contraindication to limb-sparing surgery, but with the development of vascular and nerve reconstruction technology, limb-sparing treatment is possible for these patients as well. The main methods of clinical limb preservation surgery include artificial prosthesis replacement, allogeneic bone grafting, autologous bone grafting, and tumor bone inactivation and replantation. Artificial joint replacement is currently the most widely used method. Artificial joints have significant advantages over other surgical procedures, as they allow early weight bearing, restoration of joint function, and reduction of systemic complications. Currently, the artificial joints used in osteosarcoma treatment are mainly customized according to the patient’s condition. The availability of these prostheses gives the surgeon greater choice in the scope of tumor removal and reconstruction, further increasing the scope of limb-preserving treatment. To avoid the need to revise the entire artificial joint in case of wear and tear or fracture, a grouped artificial joint can be used, and only the damaged part can be renewed if necessary. For adolescent and pediatric patients, as the limb will continue to grow, adjustable artificial joints are available, and the physician can periodically adjust the prosthesis to lengthen it to avoid postoperative limb inequality. However, artificial prostheses also have problems with postoperative infection, joint wear, fracture and long-term loosening of the prosthesis, and they are also more expensive. Allogeneic bone grafting can preserve the shape, size and strength of the bone and preserve the soft tissue attachment points for reconstruction. Allograft bone is osteoinductive and osteoconductive, and can achieve the bony healing desired by orthopedic surgeons. However, it takes a long time to heal, may suffer from bone discontinuity, fatigue fractures, and infection, and its immune rejection has not been fully resolved. Inactivated tumor bone replantation refers to the use of various methods to inactivate the tumor tissue after the autologous tumor bone is amputated, and then the inactivated bone is replanted, which has the advantages of better biological reconstruction effect as well as convenient extraction and good biocompatibility, but the inactivation process may lead to the reduction of bone strength, and may also damage the articular cartilage and affect the joint function. Composite reconstruction with allograft bone or autologous bone and metal prosthesis can achieve the complementary advantages of the two, which can reconstruct the attachment of articular cartilage, ligaments and tendons, as well as obtain immediate stability, allowing patients to perform early walking and weight-bearing. However, the complications associated with both can also occur. Our hospital has been engaged in the treatment of bone and soft tissue tumors for a long time. We were the first to establish the bone tumor department in Shangrao City, and have sent our staff to Shanghai and Beijing for further training in bone tumor diagnosis and treatment, specializing in the treatment of various benign and malignant bone tumors, especially the treatment of osteosarcoma. Every year, we treat dozens of patients with osteosarcoma, and the development of limb-preserving surgery has brought blessings to many patients with osteosarcoma. We have also accumulated a lot of experience in the treatment of osteosarcoma, and many patients who could not preserve their limbs in the past now have their limbs preserved through standardized neoadjuvant chemotherapy surgery and chemotherapy methods, and the long-term survival rate has also improved significantly. The diagnosis and treatment of osteosarcoma requires the cooperation of clinicians, imaging physicians, pathologists and rehabilitation physicians. Most of the pathology departments in cancer hospitals lack experience in this area because they do not have specialized wards for bone tumors. Our hospital has accumulated a lot of experience in orthopedic pathology, especially bone tumor pathology, because of the sufficient source of bone tumors and the complexity of the disease. Our department, radiology department and pathology department are combined. This ensures the correct diagnosis and the best treatment of the disease.