Bone tumors are lumps or masses of abnormal tissue that develop when cells within a bone divide uncontrollably. They can form in any bone throughout the body and can develop in any part of the bone itself. Most bone tumors are benign (not cancerous) however, some bone tumors are malignant (cancerous). Growing bone tumors destroy healthy tissue, weakening the bone and making it more susceptible to fracture. Treatment options vary depending upon the type of bone tumor.
Tumors of bone fall into several categories:
Benign: The tumor cannot spread to other sites. It may or may not cause pain or other local problems. Examples include osteochondromas or enchondromas. These tumors can often be removed, or if they are not causing any problems may be observed over time with serial imaging such as an X-Ray every 6 months.
Benign, Locally Aggressive: These tumors cannot spread to other sites, but can cause bone destruction, pain, fracture, or other bony problems. These tumors also have a higher tendency to come back once removed. These tumors are usually treated with surgery to remove the tumor.
Malignant: This is primary cancer of bone. These tumors are called sarcomas, and can spread to other sites, and can be very aggressive and destructive. Examples of malignant bone sarcomas include osteosarcoma, chondrosarcoma, Ewing Sarcoma, and others. The management of these cancers is complex and requires a multidisciplinary team of medical oncologists, radiation oncologists, surgeons, pathologists, and radiologists, and sometimes others. These tumors are usually treated in centers with experience in treating sarcomas, such as the Kimmel Cancer Center at Jefferson. Individualized treatment plans are made for every patient after multidisciplinary review of each patient's case. Your orthopaedic oncologist will review the exact treatment plan with you, and help guide you through the necessary treatment.
Metastatic Disease: This is the name given for a tumor that came from another site. For instance, if a patient has breast cancer, and the cancer spreads from the breast to the bone, this is called “metastatic breast cancer to bone”. The concern is that when cancer spreads from another site to bone, it can cause pain, but also may increase the risk of a fracture in that area, known as a pathologic fracture. Cancers that commonly spread to bone are Breast, Lung, Prostate, Thyroid, and Kidney cancer, although many other cancers can and do spread to bone as well. Your orthopaedic oncologist works closely with your other physicians in a team approach, including your medical and radiation oncologist, to come up with the best treatment plan to avoid pain and fracture, maintain maximum mobility and function, and limit the amount of downtime between surgery and your medical treatments.
Symptoms
- Dull and aching pain in the area of the tumor
- Pain that worsens at night
- Pain that increases with activity
- Fever
- Night sweats
- Painless mass
Causes
- Most often the cause is unknown.
- In some cases, an injury can cause a tumor to start hurting or can even cause bone weakened by a tumor to fracture.
Risk Factors
- Children whose skeletons are still growing (benign)
- Bone injury
- Family history/genetics
- Previous radiation treatment
Prevention
- Early detection and management
Diagnosis
Your doctor will discuss your symptoms, review your complete medical history, and perform a thorough physical examination.
- Physical Examination:
- The presence of a mass
- Swelling or tenderness near the tumor
- Changes to the overlying skin
- Any effect the tumor may have on nearby joints
- Tests:
- X-rays to determine the presence and exact location of a bony mass
- Biopsy to confirm the diagnosis of a bone tumor
- Open
- Needle
Treatment
There are non-surgical and surgical treatment options for the management of non-cancerous bone tumors. Treatment for cancerous bone tumors depends upon several factors, including the stage of the cancer.
The Orthopaedic Oncology service at The Rothman Orthopaedic Institute and Kimmel Cancer Center are experienced in treating all forms of bone tumors and can recommend the best course of action for each specific case.