Bone Tumors

Abstract

Primary benign bone tumors are not common, and mostly affect children and young adults. They often are detected incidentally on imaging, but some patients present with pain, swelling, and other symptoms. The four main categories are bone-forming, cartilage-forming, connective tissue, and vascular tumors, though both the latter are rare. There is a fifth category as well, called idiopathic primary benign bone tumors. The three most common primary malignant bone tumors are osteosarcoma, Ewing sarcoma, and chondrosarcoma. Osteosarcoma is most common in children from 10 to 14 years of age. This tumor occurs most often around the knee. Ewing sarcoma is also common, mostly in teenagers. It occurs often in long bones. Chondrosarcoma usually occurs in middle age. It can be a primary tumor or occur from malignant transformation of benign bone tumors. For all these cancers, patients are instructed to avoid weight-bearing on the affected leg to help prevent pathologic fractures. Imaging is usually via X-ray, and sometimes with MRI. Metastatic bone tumors are much more common than primary bone cancers, especially in adults. Most of them metastasize from primary tumors of the breasts, lungs, kidneys, prostate, thyroid, or colon.