The Epidemiology of Benign Proliferative Processes of the Skeletal System in Children.

Michal Rutkowski,Kinga Niewinska

doi:10.3390/ijerph18179338

Abstract

A suspicion of a proliferative bone lesion in a child seems to be a major diagnostic problem for clinicians. There are no diagnostic and treatment algorithms described in the literature and no reliable cohort epidemiological data. Our study was conducted among 289 paediatric patients (0–18 years old) with an initial diagnosis of a bone tumour or tumour-like lesion. The study comprised a retrospective epidemiological analysis, an assessment of the concordance of the initial diagnoses with the histopathological diagnoses and an analysis of the specific locations of the various bone lesions. The results obtained have made it possible to formulate the following conclusions. (1) The most common proliferative bone lesion in children is osteochondroma; also common are fibrous dysplasia, non-ossifying fibromas and bone cysts. (2) Verifying the initial diagnosis by means of biopsy is essential. (3) Osteochondromas are typically located in the metaphyses of long bones, fibrous dysplasia in the femur and skull, cyst-like lesions in the proximal humerus and non-osteochondral fibromas exclusively in the lower limbs. What could improve the quality of treatment for children with primary proliferative bone diseases is the establishment of centres of paediatric orthopaedic oncology skilled in early diagnosis and prompt management.

Highlights

IntroductionProliferative bone lesions in children have always been a challenge for doctors, with regard to both diagnosis and treatment [1]
The widespread occurrence of benign proliferative bone lesions in children significantly exceeds the number of diagnosed malignant lesions [2]
The analysis covered patients hospitalised between 1 January 2015 and 31 December 2017 with initial diagnoses of bone tumours and tumour-like lesions

Summary

Introduction

Proliferative bone lesions in children have always been a challenge for doctors, with regard to both diagnosis and treatment [1]. The widespread occurrence of benign proliferative bone lesions in children significantly exceeds the number of diagnosed malignant lesions [2]. These lesions are frequently asymptomatic and diagnosis is often made accidentally. There are no available epidemiological data on the incidence of benign bone tumours in children. This is probably due to the often asymptomatic nature of the diseases and the fact that their incidences do not have to be recorded. Common benign bone lesions in children include solitary bone cysts, aneurysmal bone cysts, enchondromas, osteochondromas, non-ossifying fibromas and osteoid osteomas [3]

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