Bone tumor
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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Overview
Bone tumor is an inexact term, which can be used for both benign and malignant abnormal growths found in bone, but is most commonly used for primary tumors of bone, such as osteosarcoma (or osteoma). It is less exactly applied to secondary, or metastatic tumors found in bone.
Classification
Bone tumors may be classified as "primary tumors" which originate in the bone, and "secondary tumors" which originate elsewhere.
Primary tumors
Primary tumors of bone can be divided into benign tumors and cancers. Common benign bone tumors may be neoplastic, developmental, traumatic, infectious, or inflammatory in etiology. Examples of benign bone tumors include osteoma, osteochondroma, aneurysmal bone cyst, and fibrous dysplasia.
Malignant primary bone tumors include osteosarcoma, chondrosarcoma, Ewing's sarcoma, and other sarcoma types. Multiple myeloma is a hematologic cancer which also frequently presents as one or more bone tumors.
Secondary tumors
Secondary bone tumors include metastatic tumors which have spread from other organs, such as the breast, lung, and prostate. Metastatic tumors more frequently involve the axial skeleton than the appendicular skeleton. Tumors which originate in the soft tissues may also secondarily involve bones through direct invasion.
Symptoms
The most common symptom of bone tumors is pain, but many patients will not experience any symptoms, except for a painless mass. Some bone tumors may weaken the structure of the bone, causing pathologic fractures.
Treatment
Treatment of bone tumors is highly dependant on the type of tumor. Treatment for some bone cancers may involve surgery, such as limb amputation, or limb-sparing surgery (often in combination with chemotherapy and radiation therapy). Chemotherapy and radiotherapy are effective in some tumors (such as Ewing's sarcoma) but less so in others (such as chondrosarcoma).
Limb sparing or limb salvage surgery, means the limb is spared from amputation. Instead of amputation the affected bone is removed and is done in two ways (a) bone graft, in which a bone from elsewhere from the body is taken or (b) artificial bone is put in.
The other surgery is called van-ness rotation or rotationplasty which is a form of amputation, in which the patient's foot is turned upwards in a 360 degree turn and the upturned foot is used as a knee.
Types of amputation
Leg
- Below knee
- Above knee
- Symes
- Hip disarticulation
- Hemipelvectomy or hindquarter, in which the whole leg is removed with one half of the pelvis
Arm
- Below elbow
- Above elbow
- Shoulder disarticulation
- Forequarter (amputation of the whole arm, along with the shoulder blade and the clavicle)
The most radical of amputations is hemicorporectomy (translumbar or waist amputation) which removes the legs, the pelvis, urinary system, excretory system and the genital area (penis/testes in males and vagina/vulva in females). This operation is done in two stages. First stage is doing the colostomy and the urinary conduit, the second stage is the amputation. This is a mutilating operation and is only done as a last resort (e.g. when even pelvic exenteration doesn't work or in cases of advanced pelvic/reproductive cancers)
External links
- www.umdnj.edu/tutorweb Bone Tumor website created to introduce trainees in Pathology to the basic concepts in diagnosis of bone tumors.
Acknowledgements
The content on this page was first contributed by: Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4] Phone:617-525-6884
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
