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Wake Forest Baptist Approach

Orthopaedic Oncology

There are three main diagnostic groups treated in orthopaedic oncology: benign and malignant primary soft tissue tumors, primary bone tumors, and metastatic bone lesions.  Each year, more than 300 surgeries are performed for orthopaedic tumors or bone/soft-tissue related conditions.

Our team excels at limb salvage operations and have allowed functional limbs to be saved that otherwise would have required amputation. 

Due to the complexity of bone tumor cases, interdepartmental communications are frequent.  Medical and radiation oncology, and for children with bone/soft-tissue tumors, pediatric oncology, are multidisciplinary participants in the evaluation, treatment, and follow-up of these interesting and complex cases.  Clinical trials are offered from Comprehensive Cancer Center investigators and Cooperative Groups including the CALGB and Children’s Oncology Group.

 

Bone tumors

Definition:

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



Alternative Names:

Tumor - bone

Causes, incidence, and risk factors:

The cause of bone tumors is unknown. They often arise in areas of rapid growth. Possible causes include:

  • Inherited genetic mutations
  • Radiation
  • Trauma

But in most cases no specific cause is found.

Osteochondromas are the most common noncancerous (benign) bone tumors, and occur most often in people between the ages of 10 and 20. Some benign bone tumors go away on their own and do not require treatment. These benign tumors are monitored periodically by x-ray.

Cancers that start in the bones are referred to as primary bone tumors. Cancers that start in another part of the body (such as the breast, lungs, or colon) are not considered bone tumors. Multiple myeloma often affects or involves the bone, but is not considered a bone tumor.

Cancerous (malignant) bone tumors include:

The most common cancers that spread to the bone are cancer of the:

  • Breast
  • Kidney
  • Lung
  • Prostate
  • Thyroid

These forms of cancer usually affect older people.

Bone cancer was once very common among people who painted radium on watch faces (to produce glow-in-the-dark dials). The painters 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 practice of using radium paint was abandoned in the middle of the 20th century.

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



Symptoms:

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

Note: Some benign tumors have no symptoms.



Signs and tests:

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



Treatment:

Benign bone tumors may not require treatment, but may be looked at regularly, to check if they grow or shrink. Surgical removal of the tumor may be necessary.

Treatment for malignant tumors that have spread to the bone depends on the primary tissue or organ involved. Radiation therapy with chemotherapy or hormone therapy is often used.

Tumors that start in the bone (primary malignant tumors of the bone) are rare and require treatment at centers with experience treating these cancers. After biopsy, a combination of chemotherapy and surgery is usually necessary. Radiation therapy may be needed before or after surgery.



Support Groups:

You can often help the stress of illness by joining a support group where members share common experiences and problems. For this condition, see cancer - support group.



Expectations (prognosis):

The outlook depends on the type of tumor. The outcome is expected to be good for people with noncancerous (benign) tumors, although some types of benign tumors may eventually become cancerous (malignant).

With malignant bone tumors that have not spread, most patients achieve a cure. Because the cure rate depends on the type of cancer, location, size, and other factors, discuss your situation with your doctor.



Complications:

  • Pain
  • Reduced function, depending on the extent of the tumor
  • Side effects of chemotherapy (depending on the type of chemotherapy)
  • Spread of the cancer to other nearby tissues (metastasis)


Calling your health care provider:

Call your health care provider if you have symptoms of a bone tumor.



References:

Skubitz KM, D'Adamo D. Sarcoma. Mayo Clin Proc. 2007;82:1409-1432.




Review Date:3/24/2008
Reviewed By:Stephen Grund, MD, PhD, Chief of Hematology/Oncology and Director of the George Bray Cancer Center at New Britain General Hospital, New Britain, CT. Review provided byVeriMed Healthcare Network. Also reviewed byDavid Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Copyright: Wake Forest University School of Medicine and North Carolina Baptist Hospitals. All rights reserved.

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Winston-Salem, NC 27157

The information on this Website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified healthcare provider. If you have a medical problem or a health-related question, consult your physician or call Health On-Call at 336-716-2255 or 1-800-446-2255.

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Last Modified: 9/9/2006