Bone tumors

Bone tumors consist of a mass formed within a bone or on the surface of a bone. Amass can be either benign or cancerous, depending upon what it consists of and how the tumor is formed. A bone tumor is found most often on the femur (thighbone) or tibia (shinbone). The femur and tibia are important in helping the body perform necessary functions such as jumping and walking. Since these bones often are responsible for bearing the weight of the body and in performing important actions, many bone tumors require treatment or close observation.

Overall, bone tumors are quite common, and most are the result of benign conditions.  Many bone tumors are related to disease processes in other parts of the body.  Malignant (cancerous) tumors that originate in the bone, however, are relatively rare.  Each year, approximately 2,000 Americans are diagnosed and treated for a primary malignant bone tumor. The majority of those treated are children. In fact, bone sarcomas account for around two percent of all cancer cases in children. Adolescents and young adults may be more susceptible to formation of a bone tumor due to changes related to the rapid growth during the adolescent growth spurt. When certain tumors are left untreated, they can spread, causing significant pain, possible fracture, limb amputation or death.

Anatomy of the bone

The 206 bones in the adult human body are there to shape it and provide stability. Each bone consists of the following:

  • Cartilage at the end of each bone to protect the subchondral tissues and provide a smooth gliding surface for joint movement
  • Periosteum, which is a layer of tissue that surrounds the bone, supporting bone growth, healing and remodeling
  • Compact and cancellous bone, which make up the outer and inner portion of the shaft of the bone, and provide the primary supply of calcium in the body
  • Tunnels through the bone filled with blood vessels, along which nutrients are delivered and stored
  • Bone marrow, which is a major source of blood cells that are vital to survival

Muscles attach themselves to the bones to help provide strength and stability as a person moves. Bones also protect the vital organs. 

Causes

The cause of most bone tumors is still unclear. Because the tumors typically occur in longer bones, which are sites for rapid growth, some researchers have assumed the following as possible causes:

  • Genetic alterations – Bone tumors are found most often in the growing bodies of children, which has led researchers to believe that they are formed as a result of the changes related to rapid growth. Some genetic alterations have been closely linked to certain bone tumors.
  • Trauma – Significant trauma to the bone can cause it to heal incorrectly. This incorrect healing occasionally can lead to chronic irritation, which ultimately may result in the formation of bone tumors.
  • Radiation – When children or young adults go through radiation for treatment of some forms of cancer, the cells within bones may develop genetic alterations that can lead to tumors on the bones. 

Symptoms

Depending on the severity of the bone tumor and the type, the symptoms can vary. Many patients with a bone tumor will have pain, tenderness, or swelling in and around the bone in question.

The following are bone tumor symptoms. Because every person reacts differently to these tumors, it is important to note that you do not have to have all symptoms to have a bone tumor:

  • Unexplained bone fractures
  • Pain and swelling at the site
  • Pain as a result of activity
  • Tenderness over the affected area
  • More intense pain at night
  • Fatigue

Bone tumor symptoms are similar to symptoms found with other diseases or traumas. It is important to seek the guidance of a trained professional and have tests done immediately to determine if your symptoms are a result of a bone tumor.  

Types

Bone tumors come in a variety of forms, and most require some sort of treatment:

  • Aneurysmal bone cyst (ABC) – An ABC forms as a benign bone tumor consisting of a cyst filled with blood.  Aneurysmal bone cysts may occur on their own, or may be a response to another tumor in the same location.
  • Chondroblastoma – This type of benign, yet aggressive bone tumor bears some resemblance to cartilage, and most commonly occurs near the ends of bones in children.
  • Chondromyxoid fibroma – This rare type of benign, but potentially aggressive bone tumor is most commonly found in children and young adults.
  • Giant cell tumor – A bone tumor that acts aggressively within bone. It is named for the giant cells that comprise one of the cell populations seen under the microscope.  
  • Osteoblastoma – This type of benign tumor is unique in that it actually creates bone, usually in children and young adults. This is most often seen along the spine or in long bones.
  • Osteoid osteoma – This is a smaller benign bone tumor that is closely related to osteoblastoma. It is often intensely painful, and usually produces a wall of bone formation around the tumor as a local reaction.

The multidisciplinary team of musculoskeletal oncology experts at Northwell Health Orthopaedic Institute treats bone tumors as well as a broad range of conditions that affect the bones.

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