Bone Tumor: Types and Diagnosis

What Is Bone Tumor?

The formation of a mass or lump of tissues during the uncontrollable division of cells is known as a tumor. The healthy tissues are generally replaced by the abnormal tissue in case of a growing tumor. A bone tumor usually appears on your bone and might weaken it so much that it fractures in the end. Healthy tissue will be replaced by abnormal tissues if the tumor grows. A dull pain in the affected bone is the most common symptom.

The tumors that are cancerous in nature are called malignant and can spread from one part of the body to another. However, not all tumors are malignant. Some of them are not cancerous in nature and are termed as benign. Although such tumors are not life threatening and do not metastasize to other organs of the body, they have to be treated to avoid complications. If the benign tumors are growing, they can start compressing the healthy bone tissues.

Types of Bone Tumors

1. Benign Bone Tumors

Benign tumors are more prevalent than malignant tumors. Osteochondroma is the most common kind of benign tumor according to the findings of the American Academy of Orthopaedic Surgeons. Around 35 to 40 percent of benign tumors are diagnosed as osteochondroma.

Type

Common Affected Part

Common Affected Group

Osteochondromas

The femur (thigh bone), humerus (upper arm bone) and the tibia (lower leg bone)

More common in children

Non-Ossifying Fibroma Unicameral

A solitary cyst in the leg

More common in adolescents and children

Giant Cell Tumors

The rounded end of the bone

More common in adults

Enchondroma

Long bones of thigh and arm as well as in hands and feet

Start growing in children and persist until they become older

Fibrous Dysplasia

Gene mutation that makes bones weak and fibrous

More common in adults

Aneurysmal Bone Cyst

Blood vessel abnormality that starts in the bone marrow

More common in children

2. Malignant Bone Tumors

A malignant bone tumor can be produced by a number of different kinds of cancer. There are two types of malignant bone tumors which are known as primary and secondary bone tumors.

  • ŸPrimary bone tumors

Primary bone tumor is one in which the bones are the starting point that the cancer is originated. According to the findings of the National Cancer Institute (NCI), less than one percent of cancers are diagnosed as primary bone cancer. Chondrosarcoma, osteosarcoma and Ewing sarcoma family of tumors are the three most common forms of primary bone cancers.

Type

Common Affected Part

Common Affected Group

Osteosarcoma

Upper arm and knee

Generally in young adults and teenagers

Ewing's sarcoma

Lump on shin bone, ribs, upper arm and pelvis

Young people having ages between 5 and 20

Chondrosarcoma

Arm, leg, shoulder and pelvis

People with ages between 40 and 70

  • Secondary bone tumors

Secondary bone cancer is one in which the cancer does not originate in the bones, but spread to it after having metastasized from a different part of the body. This type of cancer is common in elderly people. Cancers that have a tendency to metastasize to the bone include:

  • Ÿ   Prostate
  • Ÿ   Thyroid gland
  • Ÿ   Lung (particularly osteosarcoma)
  • Ÿ   Breast
  • Ÿ   Kidney

The multiple myeloma is the most common kind of secondary bone cancer. It is characterized by tumors that are formed in the bone marrows. Multiple myeloma mostly targets the people who fall in the 50 to 70 age group.

Diagnosis of Bone Tumors

1. Physical Examination

A physical examination is the first step in the diagnosis of bone tumors. The doctor examines the area where the tumor is supposed to be present. He/she will test the range of motion as well as the state of the bone. Family medical history might also be discussed.

2. Blood and Urine Tests

Blood and urine tests are the second step during the diagnosis of bone tumors. Analysis of these fluids will be done in a lab to detect the presence of proteins which may confirm the tumor diagnosis.

The alkaline phosphatase test is the best when it comes to diagnosing bone tumors. It is an enzyme which is released in blood during the producing of cells by bone tissue. If this enzyme is found in large quantities in blood, it means that abnormal bone tissue is being produced because of a tumor. The result of this test is more reliable for adults.

3. Imaging Tests

The size and location of the tumor can be assessed by x-rays and other imaging tests like: 

  • CT (Computed Tomography) or CAT (Computerized Axial Tomography) scan is a test that creates detailed images of the inside part of the body from several angles.
  • MRI (Magnetic Resonance Imaging) is a test that creates detailed images of the area where the tumor may be present.
  • PET (Positron Emission Tomography) scan is a test in which radioactive sugar is injected in the veins and the location of the tumor is detected as its cells consume more glucose.
  • Angiogram is simply an X-ray of the blood vessels.

4. Biopsies

A bone biopsy is generally performed to confirm the diagnoses. It is a test in which a small sample of tumor tissue is taken and examined under a microscope. There are two types of biopsies. The first one is the needle biopsy in which a needle is used to get the bone tissue sample while the second one is the incisional biopsy in which an incision is made to remove the tissue sample.

The decision regarding the treatment for the bone tumor is made after it has been properly diagnosed. Some of the benign tumors don’t require treatment and will heal on their own. However, your doctor will conduct x-rays and other imaging tests on a regular basis to monitor the state of the tumors.

The originating point of the cancerous bone tumor will decide the course of treatment for tumors that have metastasized from somewhere else in the body. A combination of surgery and chemotherapy are considered the best form of treating cancerous tumor. Radiation therapy can be used for relieving pain and preventing fractures, or used after surgical removal of the tumor.