Excision of tumor

Orthopaedic tumor treatment addresses bone tumors (abnormal growths appearing in bone tissue), usually in the form of a lump or mass. They appear when cells — for reasons not yet fully understood — divide and grow in an irregular, uncontrolled way. When a tumor forms in a bone, it can begin taking the place of normal, healthy tissue, weakening the bone’s structure and making it more susceptible to fracture.

Most bone tumors are benign — in other words, not cancerous or life threatening. In some cases, a malignant, cancerous tumor arises, and its cells may be spread to other parts of the body through the blood or lymphatic systems. With either type of tumor (benign or malignant), your doctor may determine that the best course of treatment is tumor surgery, also known as excision of tumor.

A bone tumor can sometimes cause considerable discomfort and limit your use of the limb or joint affected. In some cases, a malignant bone tumor can be fatal, particularly if the cancer spreads to other parts of the body (metastasizes). If you have any reason to suspect that you have a bone tumor, you may in fact need tumor treatment, so it is very important that you seek immediate medical attention. 

Diagnosis and testing

To diagnose your condition, your doctor will ask you questions about your medical history and the symptoms you have been experiencing and will perform a physical exam. If it is uncertain whether a tumor is present, or if the character of a tumor is unknown, one of more of these tests can help answer these questions:

  • X-Ray (radiograph) – The initial test used in the majority of cases is the familiar X-ray, also known as a radiograph. A particular type of electromagnetic radiation capable of passing through the body is used to create images of the area of the suspected tumor. Because tumor tissue absorbs X-ray radiation differently from the way normal tissues surrounding it do, the radiograph will reveal the tumor’s presence and so open the door to effective tumor treatment.
  • Computed tomography scan (CT or CAT scan) – CAT scan technology makes combines X-ray imaging with computer equipment and programming to produce detailed — even 3D — images of the body. The technique allows closer study of the tissues for diagnosis and treatment planning and for guiding tumor surgery where needed.
  • Magnetic resonance imaging (MRI) – Magnetic resonance imaging makes use of entirely different principles than those of X-ray or CAT scan imaging. A powerful magnetic field, precisely aimed radio waves and advanced computer technology are used to produce highly detailed images of the body. MRI is particularly useful in determining what types of tissues are present, making it an excellent tool for spotting unhealthy tissues such as tumors.
  • Blood tests – Blood may be drawn and analyzed in the laboratory to detect any signs that a bone tumor (particularly a cancerous one) is present.
  • Biopsy – A biopsy is a relatively routine technique used to obtain and analyze a sample of tissue from a suspected tumor. In one type of biopsy, a local anesthetic is given, a needle is inserted into the tissue and a small sample is withdrawn and taken to the laboratory for analysis. In some cases, an open biopsy is performed under anesthesia, a small incision is made and a tiny tissue sample is taken and analyzed.

Nonsurgical treatment

If a bone tumor is found to be benign, your doctor may recommend that it simply be observed, without any active treatment. In many cases, particularly in children, such a tumor will disappear on its own.

If a tumor is diagnosed as cancerous, active tumor treatment is extremely important. The type and location of the tumor and whether or not it has begun spreading to other parts of the body determines the method or methods used.

Non-surgical bone tumor treatments include radiation therapy (using powerful X-rays to kill cancerous cells and shrink the tumor) and chemotherapy (use of cancer-killing medicines to kill tumor cells that have spread through the body).

Surgery

Since some types of benign tumors eventually may become malignant and spread, your doctor may recommend excision (surgical bone tumor removal). Excision of the tumor also may be advisable to lessen the risk of breaking a bone weakened by a tumor’s presence.

In most cases, malignant (cancerous) bone tumors must be removed through surgery. Often surgery is used in combination with radiation and chemical therapies to lessen the risk of the cancer’s spread or return. This approach is called limb salvage surgery. Only the cancerous tissue is removed, with the surrounding bone, muscles, nerves and blood vessels left intact. In some cases, bone that has been removed may be replaced by a metallic implant or transplanted bone tissue.

On occasion, when a malignant bone tumor has grown very large and other nearby tissues also are affected (such as muscle or blood vessels), amputation is necessary to eliminate the cancerous tissues and safeguard the rest of the body.

Research

Ongoing research in the field of genetics is providing new insights into the nature of bone tumors of all types, benign and malignant. New understanding may open the door to innovations in tumor treatment.
 
Similarly, research in the area of medication and other treatment methods offers new approaches and more combinations of surgical excision with other therapies.
 
Finally, where amputation cannot be avoided to save a patient’s life, new discoveries and technological advances now also offer better, more comfortable and natural prosthetics, allowing patients to return to more active, normal lives.
 
Because of the importance of all of these types of research, your doctor may wish to discuss the possibility of your participating in a clinical research trial in connection with treatment of a bone tumor. Participation in such trials is always entirely voluntary; it may lead to a better outcome for you, and also for many others in the future.
 
The multidisciplinary team of musculoskeletal oncology experts at Northwell Health Orthopaedic performs tumor surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones.

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