BONE TUMORS

The cause of bone tumors is unknown. They may arise in areas of rapid growth. Other theories site heredity, trauma, and radiation as other possible causes.

What is a Bone Tumor?

A bone tumor is an abnormal growth of cells within the bone that may be benign or malignant (cancerous).

Bone tumors may be benign or malignant. Osteochondromas are the most common benign bone tumors and occur most often in people between the ages of 10 and 20. Some benign bone tumors regress on their own and do not require treatment. These benign tumors are monitored periodically by X-ray.

Malignant bone tumors occur as a primary bone tumor, or as metastasis (cancer spread from another area of the body). Primary bone tumors are rare (less than 1% of all malignant tumors) and are more common in young men.

Malignant bone tumors include osteosarcomas, Ewing's sarcoma, fibrosarcoma, and chondrosarcoma. Metastatic lesions to the bone usually arise from cancer of the breast, lung, prostate, kidney, and thyroid. These forms of cancer usually affect older people.

Bone cancer was prevalent among individuals who painted radium on watch faces (to produce glow-in-the-dark dials), a practice that was abandoned at mid-century. The painter would 'tip' the brush with their tongue (in order to produce fine work) and absorb minute amounts of radium which deposited in the bone and caused cancer.

The incidence of bone cancer is also increased in families with a history of familial cancer syndromes. The incidence of bone cancer in children is approximately 5 cases per million children each year.

What are the Symptoms of Bone Tumors?

  • Bone pain, may be worse at night
  • Occasionally a mass and swelling can be felt at the tumor site
  • Bone fracture, especially fracture from slight trauma

Note: Some benign tumors have no symptoms.

How are Bone Tumors Diagnosed?

  • X-ray of bone
  • Bone biopsy
  • Bone scan shows size and location of tumor
  • Alkaline phosphatase may be elevated

This disease may also alter the results of the following tests:

  • PTH
  • Serum phosphorus
  • Joints X-ray
  • Hands X-ray
  • Extremity X-ray
  • Calcium (ionized)
  • Serum calcium
  • ALP (alkaline phosphatase) isoenzyme

What is the Treatment for Bone Tumors?

Benign bone tumors may not require treatment, but may be assessed periodically to check for progression or regression. Surgical removal may be necessary.

Treatment for metastatic malignant tumors depends upon the primary tissue or organ involved. Radiation therapy with chemotherapy or hormone therapy is commonly used.

Primary malignant tumors are rare and require treatment at centers with experience treating these tumors. After biopsy, usually a combination of chemotherapy and surgery is necessary. Radiation therapy may be indicated before and after the surgery.

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