In general any abnormal growth in the bone may be called as tumor. It may be of two types
The major difference being that malignant tumors are more aggressive and they spread to other parts of the body - A phenomenon known as metastasis. In common language these malignanat tumors are referred as bone cancer.
Broadly they are of two types
The primary tumors arise from bone itself whereas the secondary tumors have their origin in some other organ and then spread to the bone by a phenomenon called as metastasis. Primary tumors may be furthur divided into
Benign tumors remain localised to a particular bone and does not have a tendency to spread to other parts of the body. They cause local symptoms based on their site , size and biological behaviour. Examples are Giant cell tumors
Bone cysts etc... Malignant tumors have a more aggresive behaviour and they tend to spread to the other parts of the body and can be fatal if not treated appropriately.
Classification is mostly based upon the tissue of origin of the tumor cells and the type of matrix component present in the tumor. Given below is a chart which gives an overview of the types.
The principles of treatment primarily depends upon the type of tumor whether it is benign or malignant . The general principle is that benign tumors can be treated with more function preserving surgeries like -- curettage . The malignanat tumors requires excision of the tumor along with a margin of normal anatomical tissue.-- wide excision. Usually the treatment is multidisciplinary and requires a team of orthopaedic oncologist, medical oncologist, radiation oncologist , radiologist. Currently limb sparing surgery is the standard of care in the treatment of bone cancer. When done at specialised cancer centers , it is possible to save the limb in more than 90% of cases. Many bone tumors such as osteoid osteomas, aneurysmal bone cyst , simple bone cyst etc.. can even be treated nonsurgicay or with minimally invasive modalities like radiofrequency ablations , percutaneous sclerotherapy , curopsy etc..
Usually the patient presents with pain, swelling in a bone or joint . A radographic evaluation with Xray is basic minimum . Any suspicious lesion should be evaluated in detail with furthur imaging modalities like MRI or CT scan after clinical correlation. Usually after complete clinical evaluation and radiological imaging a presumptive diagnosis is made. The diagnositic work up is completed with a biopsy which gives histological assesment of the tumors.
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