Bone tumor: types, symptoms, diagnosis and treatment

Characteristics and classification

Bone tumors are broadly classified as benign or malignant. Benign lesions such as osteochondromas or enchondromas often grow slowly and may cause local pain or deformity but do not spread. Malignant primary bone cancers include osteosarcoma, Ewing's sarcoma and chondrosarcoma; these can invade surrounding tissues and metastasize. Bone can also be a common site for metastatic disease from breast, prostate, lung and other cancers.

Signs, symptoms and diagnosis

Common symptoms include persistent bone pain, swelling, reduced joint movement, and sometimes pathological fractures after minimal injury. Diagnosis usually begins with medical history and physical examination, followed by imaging studies such as X-ray, CT or MRI and often a bone scan. Definitive diagnosis typically requires a biopsy to examine cells under a microscope and may include molecular or genetic testing for specific tumor markers.

Examples and epidemiology

Well-known primary bone cancers include osteosarcoma and Ewing's sarcoma, which most commonly occur in children and young adults. Chondrosarcoma tends to affect older adults. Benign bone tumors are more common than primary malignant bone tumors overall. Patterns of incidence vary by age group and by tumor subtype.

Treatment and prognosis

• Surgery to remove the tumor is a mainstay for many bone tumors and may include limb-sparing resection or, rarely, amputation.
• Radiation therapy and chemotherapy play key roles for certain tumors (for example, Ewing's sarcoma is often sensitive to both), while others are less responsive.
• Rehabilitation, reconstruction and long-term follow-up are important components of care to monitor for recurrence or late effects.

Decisions about management are individualized and usually made by a multidisciplinary team of orthopedic surgeons, medical and radiation oncologists, radiologists and pathologists. For more general information about bone tumors and their care, consult specialist resources or clinical centers that treat musculoskeletal cancers, and follow recommended referral pathways when a primary bone malignancy is suspected.