II. Epidemiology
- Primary Bone Cancers represent <1% of cancer diagnoses in the U.S.
III. Causes: Primary Bone Cancers
IV. Causes: Metastatic Bone Lesions
- See Metastatic Cancer involving Long Bones
- Cancers most prone to metastasize to long bones
- Breast Cancer (more common)
- Prostate Cancer (more common)
- Lung Cancer
- Renal Cancer
- Thyroid Cancer
V. Causes: Bone Marrow Involving Cancers
VI. Causes: Benign Bone Tumors
- Osteochondroma (35%)
- Giant cell tumour (20%)
- Osteoblastoma (14%)
- Osteoma (12%)
- Osteoid Osteoma (11-13%)
- Aneurysmal bone cyst (9%)
- Fibrous dysplasia (5-7%)
- Genetic Syndrome with typically benign bone lesions most often affecting femur, tibia, ribs skull, Humerus and Pelvis
- May be a part of larger syndrome
- McCune-Albright syndrome (with Cafe-Au-Lait Spots)
- Mazabraud Syndrome (with Intramuscular Myxomas)
- Enchondroma (2-3%)
- (Hakim) J Bone Oncol. 2015 Jun; 4(2): 37–41 +PMID:26579486 [PubMed]
VII. Symptoms
- Focal symptoms
- Regional or localized pain
- Extremity tenderness
- Joint decreased range of motion
- Soft tissue swelling
- Systemic symptoms
- Other presentations (less common, but more suggestive of malignancy when present)
- Night pain
- Occurs in<37% of Osteosarcomas and 19% of Osteosarcoma
- Pathologic Fracture
- Occurs in 7-8% of Osteosarcoma patients
- Night pain
VIII. Imaging
IX. Labs: Indicated for finding suggestive of Bone Cancer
X. Diagnosis
- Bone biopsy (open or needle biopsy)
- Should be performed by experienced cancer surgeon
- Needle or biopsy track should be resected with cancer to pervent local recurrence
XI. Management
- Avoid diagnostic delay
- Referral to cancer center