Bone tumors

What is it about ?

A bone tumor is not necessarily bone cancer. Indeed, a tumor can be benign or malignant. Benign tumors usually have a name that ends in -ome, while malignant tumors have a name that most often ends in -sarcoma.

Among benign bone tumors, exostoses (osteochondroma) and enchondroma are particularly common. The parrot’s beak tied to thearthritis of the vertebrae is a well-known example of exostosis (a benign bone growth). An enchondroma is a benign tumor that grows in the cartilage and progresses inside the bone. It most often affects the hand.

Malignant tumors are classified into primary tumors and bone metastases:

• primary tumors appear locally in the bone. The most common are osteosarcoma, which develops in the bone itself, usually in children and young adults, and chondrosarcoma, which develops in the cartilage and progresses into the bone, usually in older people.
• bone metastases are new cancers caused by the spread of tumors located elsewhere in the body. the breast cancer, the lung cancer, the Prostate cancer, thyroid cancer and kidney cancer are the most common cancers that metastasize into the bones.

How to recognize them?

The main symptoms are swelling in a bone or joint and pain in the tumor. To the eye, it is impossible to tell whether it is a benign or malignant tumor, or whether it is a primary tumor or a metastasis. A growing tumor is always suspicious. Osteosarcomas most often occur in the knees.

Some metastases are accompanied by additional calcification, while others weaken the bones (called bone resorption) to such an extent that they fracture quickly.

Moving the affected joint may be difficult because of the tumor.

How is the diagnosis made?

If he thinks of a bone tumor, the doctor will order an X-ray of the bone and a blood test. If these tests show a tumor, he will always refer you to a specialist who will perform additional tests such as a CT scan, an MRI exam and a bone scan.

For bone scintigraphy, a radioactive substance is injected which concentrates in the tumor and / or metastases. This makes it easier to see them.

If possible, a small bone sample will also be taken (biopsy) and sent to the laboratory for analysis. This will allow the doctor to know whether it is a slow-growing tumor or an aggressive, fast-growing tumor. This information is decisive for the treatment. These examinations are preferably carried out in the hospital where the treatment will also be started.

What can you do ?

If you notice swelling in any bone or joint, see a doctor promptly. The earlier the diagnosis is made, the better the chances of recovery.

What can your doctor do?

The doctor will only treat benign tumors if they cause symptoms, if they pose a risk of fracture, or if they are aesthetically embarrassing. They will then be removed by surgery.

Primary malignant tumors are removed where possible. In the past, this often amounted toamputation of a member. But today, the most frequent option is a local ablation with placement of an artificial joint (prosthesis) or a bone graft. If necessary, surgery is followed by radiation therapy.

With regard to bone metastases, management is assessed on a case-by-case basis. Metastases with additional calcification are treated locally with radiotherapy, which gives good results in 80 to 90% of cases. In metastases with bone resorption, spontaneous fractures are the greatest danger. Stabilization surgery is often required, followed by radiotherapy. If the tumor compresses a nerve and causes paralysis, the nerve is surgically released.

At the same time, the doctor makes sure that the pain.

The result of the treatment is then evaluated. Tumors that exhibit the following characteristics have a good prognosis:

• slow growth,
• small size,
• long period without metastases after treatment of a primary tumor,
• single metastasis,
• absence of metastases in the organs (liver, lungs, brain, kidneys),
• limited abnormalities in the blood test.

Want to know more?

• The radiography, here, Where to find on this page of Cliniques St Luc UCL
• The scanner, here, Where to find on this page of Cliniques St Luc UCL
• MRI, here, Where to find on this page of Cliniques St Luc UCL
• The scintigraphy, here, Where to find on this page of Cliniques St Luc UCL

• Bone cancer – Foundation against cancer

• Radiotherapy – Foundation against cancer

Are you looking for more specialized help?

• Cancerinfo 0800 15 801 – Information and support telephone line – Fondation contre le cancer

Source

Foreign clinical practice guide ‘Bone tumors’ (2000), updated on 02.08.2016 and adapted to the Belgian context on 08.10.2019 – ebpracticenet