Bone Tumors: Types, Causes, and Symptoms & Treatments

What is a bone tumor?

A bone tumor is an abnormal growth or mass of tissue that forms within a bone. These can be benign, which is non-cancerous, or malignant, which is cancerous. They can occur in any bone in the body.

Benign bone tumors are usually less aggressive, slow-growing, and do not spread to other parts of the body, whereas malignant tumors invade surrounding tissues and metastasize to distant areas.

The size, location of the bone tumor, as well as whether it breaks the bone’s structure and causes swelling, pain, and fractures. Diagnosis occurs through imaging tests like an X-ray, CT scans, or MRI, including biopsy to confirm the actual diagnosis.

Treatment depends upon the nature of the tumour, but surgery can be considered along with either radiation therapy or chemotherapy where the tumor is malignant.

Types of bone tumors

There are two main categories of bone tumors: benign and malignant. In each category, there are several specific types of tumors with different characteristics. Here is an overview of the main types:

Benign Bone Tumors

Osteochondroma– A benign, common neoplasm that contains a mixture of bone and cartilage; this most commonly arises close to the growth plates in long bones like the femur or tibia. It develops usually in children or in adolescence, although it usually is asymptomatic unless irritation of the adjacent tissue ensues.
Osteoid Osteoma – A small, painful benign tumor often located in the long bones like the femur or tibia. It usually causes severe pain, especially at night, which can be relieved often by NSAIDs (nonsteroidal anti-inflammatory drugs).
Osteoblastoma – A larger, benign tumor than osteoid osteomas, usually involving the spine, pelvis, and long bones. It can cause localized pain and may have to be surgically removed if it becomes large enough.
Enchondroma A benign tumor made of cartilage, often found in the small bones of hands and feet. It is often an asymptomatic lesion but, at times, it leads to fractures or deformity when it weakens the bone.
Giant Cell Tumor (GCT) – A benign yet aggressive tumor composed of multinucleated giant cells, commonly found around the knee or distal radius. Despite being non-cancerous, it can invade surrounding bone and tissue, sometimes requiring surgery or other treatments.
Chondromyxoid Fibroma – A rare benign tumor composed of cartilage and fibrous tissue, typically found in the long bones, particularly the femur or tibia. It is most common in young adults and may cause pain or swelling.
Fibrous Dysplasia This is a medical condition wherein normal bone has been replaced by fibrous tissue; this leads to bone deformities or fractures and at times is accompanied by bone pain. It can also be polyostotic with complications regarding growth and functioning.

Also Read:- Carpal Tunnel Syndrome: Symptoms, Causes & Treatment

Malignant Bone Tumors

Osteosarcoma – This is the most aggressive type of bone cancer and affects mostly the young. It usually manifests near the knee and involves aggressive treatment including surgery, chemotherapy, and sometimes radiotherapy.
Ewing’s Sarcoma – It is a very aggressive type of bone cancer which occurs primarily in children and young adults and often found in the pelvis, femur, or the ribs. Treatment usually involves chemotherapy, radiation, and surgery, and it’s associated with a particular genetic mutation.
Chondrosarcoma – This type of cancer originates from the cartilage cells, with most adults affected; most common locations are in the pelvis, femur, and ribs. Slow-growing, but may not respond to chemotherapy or radiation therapy and thus primarily treated by surgical intervention.
Fibrosarcoma: This is a rare malignant tumor that originates from fibrous tissue. Most commonly, it affects the long bones or soft tissues. It tends to grow rapidly and may require surgery, chemotherapy, and radiation therapy for effective treatment.
Multiple Myeloma – This is a cancer of the plasma cells in the bone marrow that causes multiple bone lesions, fractures, and bone pain. It is common among the elderly and usually treated with chemotherapy, stem cell transplants, and targeted therapies.
Metastatic Bone Cancer – It occurs when cells of another primary cancer such as the breast, prostate, or lungs spread to the bones. It typically results in bone pain, fractures, and weakness. Metastatic bone cancer treatment usually relies on the primary cancer’s site with additional therapies specifically targeted to the bones.

When to see a doctor

See a doctor if you experience:

Bone ache which has a pattern of persisting or even worsens at night.
Tenderness and swelling over a bone or joint.
Recurrent or unexplained fractures
Limited mobility or stiffness of the joints
Unexplained weight loss, fatigue or feeling unwell
Weakness or numbness in one limb
Fever, night sweats or drenching chills without cause
Family history of bone cancer or genetic disorder.

Symptoms of bone tumors

Symptoms of bone tumors can include:

Pain – Chronic, focal pain that gets worse over time and typically worsens at night.
Swelling – Mass or swelling seen over the affected bone or joint.
Fractures – Repeated or recurrent bone fractures for no known reason.
Restricted mobility – Stiffness or pain on movement of a joint or limb.
Fatigue – Lassitude that has no other explanation.
Numbness/tingling – Neurological signs when a nerve is compressed.
Weight loss – Loss of weight for which no cause is known.
Fever or night sweats – Usually associated with infections or cancer.

What are the causes of bone tumors?

The causes of bone tumors are not always clear, but they can include:

Genetic Factors: Inherited conditions such as Li-Fraumeni syndrome, neurofibromatosis, and Paget’s disease increase the risk.
Radiation Exposure: Former radiation therapy or environmental exposure to radiation may increase the risk of bone cancers.
Age: Some bone cancers are more common in childhood (such as osteosarcoma) or the elderly (such as chondrosarcoma).
Pre-existing Bone Conditions: Fibrous dysplasia or osteochondromas can predispose to tumour development.
Immune System Disorders: A suppressed immune system increases the risk of bone tumors.
Infections: Long-standing infections within the bone can sometimes be associated with the development of tumors.
Trauma: Multiple or severe injury to the bone can, in a few cases, be a risk for tumors.
Environmental Factors: Exposure to certain chemicals or toxins can lead to the growth of tumors.
Metastasis: Secondary bone tumors may occur when cancers from other organs (breast, lung, etc.) spread.

Risk Factors of bone tumors

Risk factors for bone tumors include:

Genetic Conditions: Inherited conditions, such as Li-Fraumeni syndrome, neurofibromatosis, and retinoblastoma.
Exposure to Radiation: Previous radiation therapy or significant environmental exposure to radiation.
Age: Bone cancers are more common in children, adolescents, and the elderly.
Existing Bone Diseases: Such diseases include Paget’s disease, fibrous dysplasia, and osteochondromas.
Weakened Immune System: Such diseases include HIV and organ transplant patients.
Family History: A family history of bone cancer or genetic syndromes.
Chronic Infections or Inflammation: Prolonged bone infections can elevate the risk.
Metastatic Cancer: Other cancers (e.g., breast, prostate) spreading to the bones can cause secondary tumors.

Treatment of bone tumors

The treatment of bone tumors is determined by their type, size, place, and whether the growth is benign or malignant. The common treatment options follow:

1. Surgery

Benign Tumors: Usually treated surgically with removal of the tumor when it causes some form of pain, swelling, or weakening of the bone. The examples of such include the osteochondromas, giant cell tumors, whose treatment is surgical removal of the tumor to reconstitute normal bone structure.
Malignant Tumors: In the event of malignant bone tumors, such as osteosarcoma or Ewing’s sarcoma, a portion of the tumor including adjacent healthy tissue may be removed by surgery. Sometimes, amputation of the limb is needed but, in most cases, patients can be treated with limb-sparing surgery.

2. Radiation Therapy

Malignant Tumors: Radiation therapy is used to shrink or eliminate cancer cells, especially for tumors that cannot be removed completely with surgery, such as chondrosarcoma or Ewing’s sarcoma. It is also used as a palliative treatment for pain relief in metastatic bone cancer.
Pre-surgical treatment: Radiation can be administered pre-operatively to reduce the size of the tumor, making it easier to resect.

3. Chemotherapy

For Malignant Bone Tumors: Chemotherapy can often be used in conjunction with surgery to treat aggressively cancerous diseases such as osteosarcoma and Ewing’s sarcoma, destroying cancer cells that will prevent recurrence.
Neoadjuvant Chemotherapy: Given before surgery to shrink the tumor and make it more operable.
Adjuvant Chemotherapy: Given after surgery to kill remaining cancer cells and prevent the risk of metastasis.

4. Targeted Therapy

Used for particular forms of bone cancers, including multiple myeloma, targeted therapy can prevent cancer cells from growing by inhibiting molecular alterations. Some examples include bisphosphonates to harden bones or other specific inhibitors.

5. Immunotherapy

For Certain Malignant Tumors: Immunotherapy, which aids the immune system in identifying and destroying cancer cells, is used in clinical trials or if other treatments fail for cancers such as Ewing’s sarcoma or osteosarcoma.

6. Bone-Supporting Treatments

For metastatic bone cancer, bisphosphonates or denosumab can be prescribed to help strengthen bones and prevent fractures in cases of bone metastasis from cancers such as breast, prostate, or lung cancer.
Pain Management: Relieving pain is an essential requirement for managing bone tumor pain through medications such as NSAIDs, opioids, or nerve blockers.

7. Rehabilitation and Physical Therapy

After surgery, in cases where part of the bone or limb was excised, physical therapy should be necessary to regain function, strength, and mobility. This is particularly true in limb-sparing surgery as well as in cases recovering from fractures caused by the tumor.

8. Observation and Monitoring

For Benign Tumors: Small benign bone tumors, like tiny osteochondromas or enchondromas, may not need any kind of intervention and only follow up with imaging to watch for growth or complications.

Conclusion

At Goyal Hospital, Jaipur, we understand that bone tumor diagnosis and treatment should involve expert care and an approach that is personalized for every patient. Whether the bone tumor is benign or minimally invasive or malignant, and requires more aggressive interventions, our multidisciplinary team is committed to offering only the best care available.

We provide a wide range of treatments, including surgery, chemotherapy, radiation therapy, and targeted treatments, to ensure that each patient receives the most effective therapy based on their specific condition. Our team works closely with each patient to tailor a treatment plan that addresses not only the tumor but also their overall health and quality of life.

With advanced medical technology, compassionate care, and commitment to the well-being of the patient, Goyal Hospital is working towards delivering the best outcomes in the management of bone tumors. We will support our patients from cutting-edge surgery to rehabilitation services to follow-up monitoring at every stage of their recovery journey.

If you or your loved ones are facing problems related to bone tumors, we advise you to reach out to Goyal Hospital in Jaipur for professional consultation and treatment. We will collaborate with you towards regaining your health and wellness.