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Bone Neoplasm
Aka: Bone Neoplasm, Bone Tumor, Bone Cancer, Bone Malignancy
- See Also
- Metastatic Cancer involving Long Bones
- Epidemiology
- Primary Bone Cancers represent <1% of cancer diagnoses in the U.S.
- Causes: Primary Bone Cancers
- Osteosarcoma
- Ewing Sarcoma
- Chondrosarcoma
- 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
- Causes: Bone Marrow Involving Cancers
- Multiple Myeloma
- Lymphoma
- Leukemia
- 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]
- Symptoms
- Focal symptoms
- Regional or localized pain
- Extremity tenderness
- Joint decreased range of motion
- Soft tissue swelling
- Systemic symptoms
- Fever
- Relapsing Fever in Ewing Sarcoma
- 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
- Imaging
- XRay
- Bone lesion may be found on xray obtained to evaluate for Fracture
- MRI (preferred over CT)
- Indicated to better define bony lesions
- Metastasis evaluation
- Chest CT (PET Scan in some cases)
- Bone Scan
- Labs: Indicated for finding suggestive of Bone Cancer
- Erythrocyte Sedimentation Rate (ESR)
- Liver Function Test
- Blood Urea Nitrogen (BUN)
- Serum Creatinine
- Urinalysis
- 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
- Management
- Avoid diagnostic delay
- Referral to cancer center
- References
- Ferguson (2018) Am Fam Physician 98(4): 205-13 [PubMed]