Bone tumor
Abnormal bone growths, often metastatic, with varied symptoms and treatments.
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A bone tumor is an abnormal mass of tissue that forms within a bone. When a bone tumor is cancerous, it most often originates from a cancer that started elsewhere in the body, such as the lung, breast, thyroid, kidney, or prostate. The oldest known example of a bone tumor is an osteosarcoma found in a foot bone from South Africa, dating back between 1.6 and 1.8 million years.
Signs and symptoms
Symptoms can include a noticeable lump, pain, or neurological issues caused by the tumor pressing on nerves. A bone tumor may also lead to a fracture with minimal or no injury. Other possible symptoms are fatigue, fever, weight loss, anemia, and nausea. In some cases, there are no symptoms, and the tumor is discovered while investigating an unrelated condition.
Diagnosis
Diagnosis typically begins with an X-ray and may involve other imaging tests like CT, MRI, PET scans, or bone scintigraphy. Blood tests can include a complete blood count, inflammatory markers, serum electrophoresis, PSA, and assessments of kidney and liver function. Urine may be tested for Bence Jones protein. A biopsy, either needle or open, is often needed to confirm the diagnosis through histological evaluation.
Classification
Bone tumors are traditionally classified as benign (noncancerous) or malignant (cancerous). The World Health Organization updated this classification in 2020, grouping tumors into categories such as cartilage, osteogenic, fibrogenic, vascular, osteoclastic giant cell-rich, notochordal, other mesenchymal, and hematopoietic neoplasms.
Tumors are also divided into primary types, which originate in bone, and secondary types, which metastasize from other sites. Secondary malignant bone tumors are 50 to 100 times more common than primary bone cancers. Carcinomas of the prostate, breast, lung, thyroid, and kidney most frequently spread to bone.
Primary bone tumors
Common benign primary bone tumors include osteoma, osteoid osteoma, osteochondroma, osteoblastoma, enchondroma, giant cell tumor of bone, and aneurysmal bone cyst. Some, like osteochondroma, are hamartomas rather than true neoplasms. Malignant primary bone tumors, or bone sarcomas, include osteosarcoma, chondrosarcoma, Ewing sarcoma, and fibrosarcoma. Pleomorphic undifferentiated sarcoma (formerly malignant fibrous histiocytoma) can occur but is often reclassified with genetic and immunohistochemical tests.
Lore & Background
Bone tumors are traditionally classified as noncancerous (benign) or cancerous (malignant). Their classification was revised by the World Health Organization (WHO) in 2020, categorizing them into cartilage tumors, osteogenic tumors, fibrogenic tumors, vascular tumors of bone, osteoclastic giant cell-rich tumors, notochordal tumors, other mesenchymal tumors of bone, and hematopoietic neoplasms of bone. Primary tumors originate in bone, while secondary tumors metastasize from other sites, most commonly carcinomas of the prostate, breasts, lungs, thyroid, and kidneys.
Reader's Guide
Bone tumors present significant clinical challenges due to their varied origins and behaviors. Diagnosis typically involves X-ray and other radiological tests such as CT scan, MRI, PET scan, and bone scintigraphy, with biopsy for histological confirmation.
Treatment depends on tumor type and may include surgery (limb amputation or limb-sparing surgery), chemotherapy, radiotherapy, or thermal ablation techniques like radiofrequency ablation for benign tumors such as osteoid osteomas. Despite advances, bone cancer continues to pose difficulties, with a five-year survival rate of 68% in the United States for bone and joint cancer. The WHO's 2020 classification reflects ongoing efforts to better categorize these tumors, though reliable statistics remain elusive, especially in older adults.
Frequently Asked Questions
What is a bone tumor?
A bone tumor is an abnormal mass of tissue that develops within a bone. It may be benign or malignant, and in cancerous cases it frequently represents spread from a primary cancer located in another organ.
Where do most cancerous bone tumors originate?
In the majority of malignant cases the cancer did not begin in the bone itself but metastasized from a distant site—most commonly the lung, breast, thyroid, kidney, or prostate.
What symptoms should someone watch for with a bone tumor?
Common warning signs include a visible lump, persistent pain, neurological deficits from nerve compression, and pathologic fractures that occur with little or no trauma. Fatigue and fever may also accompany the condition.
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Sources
Compiled from Wikipedia and the sources listed below. Text from Wikipedia is available under CC BY-SA 4.0; this entry is adapted from it.
- Wikipedia: Bone tumor (CC BY-SA 4.0).
- Word definitions: the Codexery glossary, each quoted from its Wikipedia article.
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