Bone cancer or bone tumor is a general term for a wide variety of conditions that can be present in the bone, and are made up of rapidly dividing cells. Bone cancer can be present in any bone in the body. There three major types of bone tumors: benign primary bone, malignant primary bone and metastatic cancer. Common benign primary bone tumors are simple bone cysts, fibrous dysplasia, enchondroma, giant cell tumor, osteoid osteoma and osteochondroma. Common malignant bone tumors are osteosarcoma, Ewing's sarcoma and chondrosarcoma. Multiple myeloma is a tumor of the bone marrow and plasma cells that is malignant. Metastatic cancers are primary cancers of another organ that spread to other tissues in the body including bone .
Symptoms
Common symptoms of a bone tumor include pain, swelling, a growing mass, fracture and general cancer symptoms. Pain can occur that is dull and achy, but pain is not a symptom for all bone tumors, according to the "AAOS Comprehensive Orthopaedic Review." Pain typically occurs over the site of the tumor or in the region of the tumor; however, this is not always the case. For example, bone tumors in the spine can cause general back pain. Swelling of the soft tissues overlying the involved bone can also occur. A growing mass can be present, which usually represents the growing tumor. A fracture through the involved bone can occur due to minimal trauma; this is known as a pathologic fracture. General cancer symptoms include fevers, chills, night sweats, fatigue, changes in appetite and recent undesired weight loss according to MayoClinic.com. These general cancer symptoms are present in all different types of cancers.
Physical Examination
Many bone tumors may not be diagnosed by physical exam alone. Clinicians may elicit a point of tenderness overlying the bone tumor. There may be limited range-of-motion of a joint, either due to pain or physical impingement on structures by the tumor. Tumors that spread to the bone from other sources have their own physical exam findings. A thyroid, breast or prostate cancer may have a palpable mass on exam of that organ. Lung cancer can cause a cough or blood in the sputum. A kidney tumor can cause abdominal or flank discomfort on exam. There can be different findings for each kind of bone tumor.
Radiographic Diagnosis
Imaging studies to help diagnose bone tumors include a bone scan, computerized tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and x-rays, according to Mayoclinic.com. X-rays are usually the first type of imaging performed with a clinical decision made on the next most appropriate test to aid in diagnosis.
Biopsy
A biopsy involves inserting a needle through the skin into the tumor to retrieve a sample of tissue. The tissue is then prepared in a laboratory so that a pathologist can examine the cells present to determine whether the tissue is cancerous. The biopsy is typically performed by an orthopaedic surgeon or interventional radiologist.
References
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman (ed.); 2008.
- American Academy of Orthopaedic Surgeons: Bone Tumor
- Mayoclinic.com: Bone Cancer
- "Robbins and Cotran: Pathologic Basis of Disease (7th edition); Dr. Vinay Kumar, Dr. Abul Abbas, and Dr. Nelson Fausto (eds.); 2005.
