Bone Tumor

Written by Teresa Bergen | Published on May 4, 2012

Medically Reviewed by George Krucik, MD on May 4, 2012
What is a Bone Tumor?
When cells divide abnormally and uncontrollably, they can form a mass or lump of tissue. This lump
is called a tumor. Bone tumors form in your bones. As the tumor grows, abnormal tissue can displace
healthy tissue.
Some tumors are benign, meaning they are not cancerous. While benign bone tumors wont spread to
other parts of the body and are unlikely to cause death, they can still be dangerous and may require
treatment. Benign tumors can grow and could compress your healthy bone tissue. Other tumors are
malignant, meaning they are cancerous. Malignant bone tumors can cause cancer to spread throughout
the body.
Types of Benign Bone Tumors
Osteochondromas
Benign tumors are more common than malignant ones. According to the American Academy of
Orthopaedic Surgeons, the most common type is osteochondroma. This type accounts for between 35
and 40 percent of all benign bone tumors (AAOS). Osteochondromas develop in adolescents and
teenagers.
The tumors form near the ends of long bones, such as the arm or leg bones. Specifically, these tumors
tend to affect the lower end of the thighbone (femur), the upper end of the lower leg bone (tibia) and
the upper end of the upper arm bone (humerus). Basically, they are usually found at the actively
growing ends of long bones.
These tumors are formed of a combination of bone and cartilage. The osteochondroma has been
considered to be an abnormality of growth. A child may develop a single osteochondroma or many.
Non-Ossifying Fibroma Unicameral
Non-ossifying fibroma unicameral is a simple solitary bone cyst. It is the only true cyst of bone. It is
usually found in the leg and occurs most often in children and adolescents.
Giant Cell Tumors
Giant cell tumors grow aggressively. They occur in adults and in the rounded end of the bone, not in
the growth plate. These are very rare.
Enchondroma
An enchondroma is a cartilage cyst that grows inside the bone marrow. When they occur, they begin
in children and persist as adults. They tend to be part of syndromes called Olliers and Mafuccis
syndrome. Enchondromas occur in the hands and feet as well as the long bones of the arm and thigh.
Fibrous Dysplasia
Fibrous dysplasia is a gene mutation that makes bones fibrous and vulnerable to fracture.

Aneurysmal Bone Cyst

An aneurysmal bone cyst is an abnormality of blood vessels that begins in the bone marrow. It can
grow rapidly and can be particularly destructive because it affects growth plates.
Cause of Bone Tumors
The cause of bone tumors is not known. Often the tumors occur when parts of the body are growing
rapidly. A few possible causes are genetics, radiation treatment, and injuries to the bones.
Osteosarcoma has been linked to radiation treatment (particularly high doses of radiation) and other
anticancer drugs, especially in children. However, a direct cause has not been identified. People who
have had bone fractures repaired with metal implants are also likelier to later develop osteosarcoma.
Recognizing Potential Symptoms of Bone Tumors
A dull ache in the affected bone is the most common symptom of bone cancer. The pain starts off as
occasional and then becomes severe and constant. The pain may be severe enough to wake you up in
the night. Sometimes, when people have an undiscovered bone tumor, what seems like an
insignificant injury breaks the already-weakened bone, leading to severe pain. This is known as a
pathologic fracture. Sometimes there may be swelling at the site of the tumor.
Tumors can cause night sweats or fevers. Or you might not have any pain, but will notice a new mass
of tissue on some part of your body.
People with benign tumors might not have any symptoms, and the tumor might not be detected until
an imaging scan reveals it while receiving other medical testing. A benign bone tumor (such as an
osteochondroma) may not require treatment unless it starts to interfere with function and movement.
Diagnosing a Bone Tumor
Some other conditions, such as fractures and infections, might resemble tumors. To be sure you have a
bone tumor, your doctor might order a variety of tests.
First, your doctor will examine you physically, focusing on the area of your suspected tumor. He or
she will check for tenderness in your bone and test your range of motion. Your doctor will also ask
questions about your family medical history.
Blood and Urine Tests
Your doctor might order tests, including blood or urine samples. These fluids will be analyzed at a lab
to detect different proteins that may indicate the presence of a tumor or other medical problems.
An alkaline phosphatase test is one common tool used in diagnosing bone tumors. When your bone
tissue is especially active in forming cells, large quantities of this enzyme show up in your blood. This
could be because a bone is growing, such as in young people, or it could mean a tumor is producing
abnormal bone tissue. This test is more reliable in adults who have stopped growing.
Imaging Tests
Your doctor will probably order X-rays to determine the size and exact location of the tumor.
Depending upon the X-ray results, other imaging tests might be necessary, including:

CT or CAT scan, also known as computed tomography: This test produces

a series of detailed images of your insides, taken from several angles.
MRI, or magnetic resonance imaging: This test takes detailed pictures of
the area in question.
PET scan, or positron emission tomography: The doctor injects a little radioactive sugar
in your vein. Since cancer cells use more glucose than regular cells, this activity helps to
locate the site of the tumor.
Angiogram: This is an X-ray of your blood vessels.

Biopsies
Your doctor might want to perform a biopsy. In this test, a sample of the tissue that makes up your
tumor will be removed. The sample is examined in a laboratory under a microscope. The main types
of biopsies are a needle biopsy and an incisional biopsy.
A needle biopsy may be done in your doctors office or by a radiologist in conjunction with one of
the above imaging tests. Either way, youll have local anesthetic to block the pain. The doctor will
insert a needle into your bone, using it to remove a small bit of tumor tissue. If your needle biopsy is
done by a radiologist, he or she will use the image from the X-ray, MRI, or CT scan to help find the
tumor and know where to insert the needle.
An incisional biopsy, also called an open biopsy, is done in an operating room under general
anesthesia so you will sleep through this procedure. The doctor cuts an incision and removes your
tissue through it. The bone biopsy is important to make a definite determination of the condition.

Treatment for Benign Bone Tumors

If your tumor is benign, it may or may not require action. Sometimes doctors just watch benign bone
tumors to see if they change. This requires coming back periodically for follow-up X-rays. Bone
tumors can grow, stay the same, or eventually disappear. Children have a higher likelihood of having
their bone tumors disappear as they mature.
Sometimes benign tumors spread or transform into malignant tumors. Since bone tumors can also lead
to fractures, your doctor might want to surgically remove even a benign tumor.