Bone Tumors

Benign tumors
Malignant tumors
Causes
Symptoms
Diagnosis
Treatment for benign tumors
Treatment for malignant tumors
Recovery
Outlook

What is a bone tumor?

When cells divide abnormally and uncontrollably, they can form a mass or lump
of tissue. This lump is
called a tumor. Bone tumors form in your bones. As the tumor grows, abnormal
tissue can displace
healthy tissue. Tumors can either be benign or malignant.
Benign tumors aren’t cancerous. While benign bone tumors typically stay in
place and are unlikely to be
fatal, they’re still abnormal cells and may require treatment. Benign tumors can
grow and could
compress your healthy bone tissue and cause future issues.
Malignant tumors are cancerous. Malignant bone tumors can cause cancer to
spread throughout the body.
Primary Bone Tumors
June 4, 2021

Types of benign bone tumors

Osteochondromas
Benign tumors are more common than malignant ones. According to the
American Academy of
Orthopaedic Surgeons (AAOS), the most common type of benign bone tumor is
an osteochondroma.
This type accounts for between 35 and 40 percent of all benign bone tumors.
Osteochondromas develop
in adolescents and teenagers.

These tumors form near the actively growing ends of long bones, such as arm
or leg bones. Specifically,
these tumors tend to affect the lower end of the thighbone (femur), the upper
end of the lower leg
bone (tibia), and the upper end of the upper arm bone (humerus).
These tumors are made of bone and cartilage. Osteochondromas have been
considered to be an
abnormality of growth. A child may develop a single osteochondroma or many
of them.

Nonossifying fibroma unicameral

Nonossifying fibroma unicameral is a simple solitary bone cyst. It’s the only
true cyst of bone. It’s usually
found in the leg and occurs most often in children and adolescents.

Giant cell tumors

Giant cell tumors grow aggressively. They occur in adults. They’re found in the
rounded end of the bone
and not in the growth plate. These are very rare tumors.

Enchondroma
An enchondroma is a cartilage cyst that grows inside the bone marrow. When
they occur, they begin in
children and persist as adults. They tend to be part of syndromes called Ollier’s
and Mafucci’s syndrome.
Enchondromas occur in the hands and feet as well as the long bones of the arm
and thigh.

Fibrous dysplasia
Fibrous dysplasia is a gene mutation that makes bones fibrous and vulnerable
to fracture.

Aneurysmal bone cyst

An aneurysmal bone cyst is an abnormality of blood vessels that begins in the
bone marrow. It can grow
rapidly and can be particularly destructive because it affects growth plates.

Types of malignant bone tumors

There are also several types of cancer that produce malignant bone tumors.
Primary bone cancer means
that the cancer originated in the bones. According to the National Cancer
Institute (NCI)Trusted Source,
primary bone cancer accounts for less than 1 percent of all types of cancer.
The three most common forms of primary bone cancers are osteosarcoma,
Ewing sarcoma family of
tumors, and chondrosarcoma.

Osteosarcoma
Osteosarcoma, which occurs mostly in children and adolescents, is the second
most common type of
bone cancer. This usually develops around the hip, shoulder, or knee. This
tumor grows rapidly and
tends to spread to other parts of the body.
The most common sites for this tumor to spread are areas where the bones are
most actively growing
(growth plates), the lower end of the thighbone, and the upper end of the
lower leg bone.
Osteosarcoma is also sometimes known as osteogenic sarcoma. Here’s how it’s
treated and the outlook
for people diagnosed with osteosarcoma.

Ewing sarcoma family of tumors (ESFTs)

Ewing sarcoma family of tumors (ESFTs) strikes adolescents and young adults,
but these tumors can
sometimes affect children as young as 5 years old. This type of bone cancer
usually shows up in the legs
(long bones), pelvis, backbone, ribs, upper arms, and the skull.
It begins in the cavities of the bones where the bone marrow is produced (the
medullary cavities). In
addition to thriving in bone, ESFTs can also grow in soft tissue, such as fat,
muscle, and blood vessels.
According to the NCITrusted Source, African-American children very rarely
develop ESFTs. Males are
more likely to develop ESFTs than females. ESFTs grow and spread rapidly.

Chondrosarcoma
Middle-aged people and older adults are more likely than other age groups to
develop chondrosarcoma.
This type of bone cancer usually develops in the hips, shoulders, and pelvis.

Secondary bone cancer

The term “secondary bone cancer” means that the cancer started somewhere
else in the body and then
spread to the bone. It usually affects older adults. The types of cancer most
likely to spread to your
bones are:
kidney
breast
prostate
lung (particularly osteosarcoma)
thyroid gland
Multiple myeloma

The most common type of secondary bone cancer is called multiple myeloma.
This bone cancer shows
up as tumors in the bone marrow. Multiple myeloma most commonly affects
older adults.

The causes of bone tumors

The causes of bone tumors aren’t known. A few possible causes are genetics,
radiation treatment, and
injuries to the bones. Osteosarcoma has been linked to radiation treatment
(particularly high doses of
radiation) and other anticancer drugs, especially in children. However, a direct
cause hasn’t been
identified.
The tumors often occur when parts of the body are growing rapidly. People
who’ve had bone fractures
repaired with metal implants are also more likely to develop osteosarcoma
later.
Recognizing potential symptoms of bone tumors
A dull ache in the affected bone is the most common symptom of bone cancer.
The pain starts off as
occasional and then becomes severe and constant. The pain may be severe
enough to wake you up in
the night.
Sometimes, when people have an undiscovered bone tumor, what seems like
an insignificant injury
breaks the already weakened bone, leading to severe pain. This is known as a
pathologic fracture.
Sometimes there may be swelling at the site of the tumor.
Or you might not have any pain, but you’ll notice a new mass of tissue on some
part of your body.
Tumors can also cause night sweats, fevers, or both.
People with benign tumors might not have any symptoms. The tumor might
not be detected until an
imaging scan reveals it while receiving other medical testing.
A benign bone tumor, such as an osteochondroma, may not require treatment
unless it starts to
interfere with your day-to-day function and movement.

Diagnosing a bone tumor

Fractures, infections, and other conditions might resemble tumors. To be sure
you have a bone tumor,
your doctor might order a variety of tests.
First, your doctor will do a physical exam with a focus on the area of your
suspected tumor. They’ll check
for tenderness in your bone and test your range of motion. Your doctor will
also ask you questions about
your family medical history.

Blood and urine tests

Doctor may order tests, including blood or urine samples. A lab will analyze
these fluids to detect
different proteins that may indicate the presence of a tumor or other medical
problems.
An alkaline phosphatase test is one common tool doctors use to diagnose bone
tumors. When your
bone tissue is especially active in forming cells, large quantities of this enzyme
show up in your blood.
This could be because a bone is growing, such as in young people, or it could
mean a tumor is producing
abnormal bone tissue. This test is more reliable in people who’ve stopped
growing.

Imaging tests
Doctor will probably order X-rays to determine the size and exact location of
the tumor. Depending
on the X-ray results, these other imaging tests may be necessary:
A CT scan is a series of detailed X-rays of the inside of your body that are taken
from several angles.
An MRI scan uses magnets and radio waves to provide detailed pictures of the
area in question.
In a positron emission tomography (PET) scan, your doctor will inject a small
amount of radioactive
sugar into your vein. Since cancer cells use more glucose than regular cells, this
activity helps your
doctor locate the site of the tumor.
An arteriogram is an X-ray of your arteries and veins.
A bone scan may also be needed — here’s how they’re done and what the
results mean.

Biopsies
Your doctor may want to perform a biopsy. In this test, a sample of the tissue
that makes up your tumor
will be removed. The sample is examined in a laboratory under a microscope.
The main types of biopsies
are a needle biopsy and an incisional biopsy.
A needle biopsy may be done in your doctor’s office or by a radiologist along
with one of the previously
mentioned imaging tests. Either way, you’ll have local anesthetic to block the
pain.
Your doctor will insert a needle into your bone, using it to remove a small bit of
tumor tissue. If a
radiologist does the needle biopsy, they’ll use the image from the X-ray, MRI, or
CT scan to help find the
tumor and know where to insert the needle.
An incisional biopsy, also called an open biopsy, is done in an operating room
under general anesthesia
so you’ll sleep through the procedure. Your doctor will make an incision and
remove your tissue through
the incision.
Completing a bone biopsy is important to make a definite diagnosis of the
condition.
How are benign bone tumors treated?

If your tumor is benign, it may or may not require action. Sometimes doctors
just keep an eye on benign
bone tumors to see if they change over time. This requires coming back
periodically for follow-up X-rays.
Bone tumors can grow, stay the same, or eventually disappear. Children have a
higher likelihood of
having their bone tumors disappear as they mature.
However, your doctor may want to surgically remove the benign tumor. Benign
tumors can sometimes
spread or transform into malignant tumors. Bone tumors can also lead to
fractures.

How are malignant bone tumors treated?

If your tumor is malignant, you’ll work closely with a team of doctors to treat it.
Although malignant
tumors are a cause of concern, the outlook for people with this condition is
improving as treatments are
developed and refined.
Your treatment will depend on what type of bone cancer you have and
whether it’s spread. If your
cancer cells are confined to the tumor and its immediate area, this is called the
localized stage. In the
metastatic stage, cancerous cells have already spread to other parts of the
body. This makes curing the
cancer more difficult.
Surgery, radiation, and chemotherapy are the main strategies for treating
cancer.
Surgery
Bone cancer is usually treated with surgery. In surgery, your entire tumor is
removed. Your surgeon
carefully examines the margins of your tumor to make sure no cancer cells are
left after surgery.
If your bone cancer is in an arm or leg, your surgeon may use what’s known as
limb salvage surgery. This
means that while the cancerous cells are removed, your tendons, muscles,
blood vessels, and nerves are
spared. Your surgeon will replace the cancerous bone with a metal implant.
Advances in chemotherapy have greatly improved recovery and survival. New
drugs are being
introduced on an ongoing basis.
Surgical techniques have improved greatly, too. Doctors are much more likely
able to spare your limbs.
However, you might need reconstructive surgery to retain as much limb
function as possible.

Radiation therapy
Radiation is often used in conjunction with surgery. High-dose X-rays are used
to shrink tumors before
surgery and kill cancer cells. Radiation can also reduce pain and decrease the
chance of bone fractures.

Chemotherapy
If your doctor thinks your cancer cells are likely to spread or if they already
have, they may recommend
chemotherapy. This therapy uses anticancer drugs to kill the rapidly growing
cancer cells.

The side effects of chemotherapy include:

nausea
irritability
hair loss
extreme fatigue
Cryosurgery
Cryosurgery is another treatment possibility. This treatment involves killing
cancer cells by freezing them
with liquid nitrogen. A hollow tube is inserted into the tumor, and liquid
nitrogen or argon gas is
pumped in. In some cases, cryosurgery can be used to treat bone tumors
instead of regular surgery.

Recovery from bone tumor treatment

Doctor will want you to stay in close contact with them while you recover.
Follow-up X-rays and
blood tests will be necessary to make sure the whole tumor is gone and that it
doesn’t return.
need to have follow-up tests every few months.
How quickly you recover will depend on what type of bone tumor you had,
how big it was, and where it
was located.
Many people find cancer support groups helpful. If your bone tumor is
malignant, ask your doctor for
resources or inquire about groups like the American Cancer Society
(ACS)Trusted Source.

Long-term outlook
If your tumor is benign, your long-term outcome will probably be good.
However, benign bone tumors
can grow, recur, or turn into cancer, so you’ll still benefit from regular checkups.
Your outlook varies according to the type of cancer, size, location, and your
general health. Your outlook
is also good if the bone is localized.
Both malignant and benign bone tumors can recur. People who have had bone
cancer, especially at an
early age, are at higher risk of developing other types of cancer. If you have any
symptoms or health
concerns, be sure to discuss them with your doctor promptly.

Conclusion:

In conclusion, bone tumors encompass a diverse group of neoplasms that can

vary in severity and
aggressiveness. Early detection, accurate diagnosis, and appropriate treatment
are essential for optimal
patient outcomes. With ongoing research and advancements in treatment
approaches, there is hope for
improved prognosis and quality of life for individuals affected by bone tumors.
Bibliography:
Dorfman, H. D., & Czerniak, B. (1998). Bone tumors. Mosby-Year Book.
Mirabello, L., Troisi, R. J., & Savage, S. A. (2009). International
osteosarcoma incidence patterns in
children and adolescents, middle ages and elderly persons. International
journal of cancer, 125(1),
229-234.