Bone tumors

Bone tumors are more common in those under 15 years of age and in the elderly with a somewhat higher frequency in men.

The classification of bone tumors is complex. In general, they are divided into benign tumors Y malignant tumors.

• The benign tumors they are made up of cells of normal tissue, have a slow growth and do not invade neighboring structures.
• The malignant tumors They are formed by cells different from those of normal tissue, they grow rapidly, invade neighboring structures and can reproduce at a distance, giving metastasis.

Benign bone tumors include osteoma, chondroma, osteochondroma, lymphangioma, and hemangioma.

The most common malignant tumors are multiple myeloma, osteosarcoma and the Ewing sarcoma.

How is it produced?

Abnormal cell proliferation and increased bone metabolism have been associated more frequently in growing children with bone tumors in the femur and tibia. Previous radiation is also considered a cause of bone tumors, as well as the malignancy of previous benign tumors.

Symptoms

The symptoms are usually very nonspecific. The pain may not be very severe, even if the tumor is slow growing, it may be missing. When there is pain, it is localized and typically appears at night.

In some cases there is an increase in volume due to tumor growth or deformation due to the presence of a pathological fracture (secondary fracture without previous trauma or with minimal trauma) which in some cases is the first symptom.

When symptoms such as anorexia, weight loss, asthenia or fever appear, consider the existence of a malignant tumor.

In general, the different types of tumors appear more frequently in certain age ranges and in certain locations.

Diagnosis

Diagnosis of bone tumors is based on the clinic, imaging tests, and the characteristics of the cells.

Plain radiography is the first test to request. It shows the location, boundaries, shape, and density of the tumor. A benign tumor is well demarcated with normal bone structure. A malignant tumor invade and destroy the bone where it has occurred, the normal contours are missing, have no clear boundaries, and invade the surrounding tissue. It can be osteoforming (bone forming), giving characteristic radiological images such as "in the rising sun", in "onion layers" or "hairy edge" and osteolytic (bone destroyer).

The is the most accurate test to determine the extent of the bone tumor. It allows to precisely define the edges of the tumor and its extension. It is the choice when adjacent soft tissue involvement is suspected.

Computed tomography is useful for the preoperative evaluation of tumors, providing information on the size of the tumor mass, its location and its relationship with the adjacent muscles.

The tumor biopsy It is performed with a fine needle (FNA) or open biopsy, depending on the characteristics of the tumor.

In the case of bone metastases, the study of the patient is directed to the search for the primary tumor.

Treatment

The surgery it is the treatment of choice for most tumors, whether benign or malignant. Some benign tumors that are not operated on will subsequently require regular imaging checks to follow their evolution.

In malignant tumors, treatment is individualized based on the characteristics of the tumor and its extent. Surgery is the treatment of choice, whether or not it is accompanied by chemotherapy before or after it.

Radiotherapy is used in cases of spinal involvement due to the existence of metastases, after surgery or as palliative treatment in bone metastases not subject to surgery in order to improve pain.