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Orthopedics

Bone and Soft Tissue Tumor

Bone tumors are masses formed by the uncontrolled proliferation of bone-forming cells or other tissues within bone. They may be benign or malignant.

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ℹWhat is Bone and Soft Tissue Tumor?

Bone tumors can affect any bone in the body. A growing bone tumor, even if it is benign, destroys healthy tissue and makes the bone more susceptible to fractures.

Classification by Behavior

  • Benign Tumors: Grow slowly, do not spread to surrounding tissues, and do not metastasize. However, they can weaken the bone.

  • Primary Malignant Tumors: Start directly from the bone tissue.

  • Secondary (Metastatic) Tumors: Occur when cancer from another organ spreads to the bone.

Classification by Tissue

  • Osteogenic: Osteoma, Osteoid Osteoma, Osteoblastoma (benign); Osteosarcoma (malignant).

  • Chondrogenic: Enchondroma, Osteochondroma, Chondroblastoma (benign); Chondrosarcoma (malignant).

  • Giant Cell Tumor: Generally benign but locally aggressive.

  • Ewing Sarcoma: An aggressive cancer originating from the bone marrow or soft tissue.

Common Symptoms

Pain
Dull, aching pain at the tumor site. May worsen at night and increase with physical activity.
Painless Mass
In many patients, a painless lump may be the only finding.
Pathological Fracture
Fracture of a bone weakened by tumor after trauma. Causes severe pain.
Systemic Symptoms
Fever and night sweats. May be discovered incidentally on radiographs.

Diagnosis Methods

Physical Examination
Pain character, duration of swelling, warmth, tenderness, and range of motion are assessed.
X-Ray
First-line imaging. Shows bone destruction and tumor boundaries.
CT
Superior to MRI for detecting cortical damage and calcifications.
MRI
Best shows the soft tissue spread of the tumor, vessel/nerve relationship, and bone marrow status.
Bone Scintigraphy and PET-CT
Scanning the entire body for metastasis and determining the biological activity of the tumor.
Laboratory Studies
ALP, LDH (Osteosarcoma), ESR/CRP, M-Protein and Bence-Jones Protein for Multiple Myeloma.
Biopsy
CT-guided needle biopsy or open surgical biopsy for definitive diagnosis.

Treatments

Curettage
Removal of the tumor by scraping it from inside the bone. Applied in benign tumors; the cavity is filled with a graft or cement.
Wide Resection
Removal of the tumor along with the surrounding healthy tissue. Prevents the recurrence of malignant tumors.
Limb-Sparing Surgery
The majority of bone cancers are treated without the need for amputation. Prostheses or other bones are implanted.
Chemotherapy
Common in Osteosarcoma and Ewing Sarcoma. Neoadjuvant (shrinking the tumor before surgery) and adjuvant (post-surgery) chemotherapy.
Radiotherapy
Used for radiosensitive tumors such as Ewing Sarcoma and for palliative purposes.
Radiofrequency Ablation and Cryosurgery
Treatment with heat or freezing for small tumors such as Osteoid Osteoma.
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