Bone tumors and their symptoms?

The way in which bone tumors appear varies widely. For some patients, as is common in many cases of asymptomatic tumors, there is an “incidental” finding of bone lesions. In such situations, the patient may seek the help of a specialist to learn more about the type of cancer in their bones. However, many people learn that it’s a benign lesion at this stage.

Bone tumor symptoms can present themselves due to a fracture or a swelling of the leg. It could also be because of the presence of a bone tumor that is noticeable on palpation. Both bone cancers (malignant) and bone tumors (benign) can present themselves in this way, so an evaluation with the orthopedic oncology specialist is imperative for an accurate diagnosis.

The doctor will utilize your clinical history, physical examination, and imaging tests to determine the diagnosis. Such as, for example, on the differential diagnosis of chondrosarcoma and enchondroma.

Bone tumor symptoms

Most bone tumors are benign, however, seeking medical assistance is necessary to ensure you’re safe and healthy. All orthopedic generalists will encounter these injuries when they are working in the emergency room, they will find injuries such as the chondroma, osteochondroma, degenerative cysts, simple bone cyst, non-ossifying fibromas, and many others. In cases where the pain improves with the use of analgesics, it’s a sign that there was a benign lesion. These are generally associated with some activity that the patient performed or may also relate to some trauma sustained.

Some tumors are clearly noticeable on the radiographic image, doing away the need for any further investigation. This is the case for non-ossifying fibroma, osteoid osteoma, and unicameral bone cysts.

Image study of bone tumors

The radiological evaluation of the tumor in the bones begins with the radiography of the entire bone that is involved with the lesion. Usually, the tumor in the benign bone has well-defined margins due to sclerotic borders and may present tapering of the endosteum. Additionally, there will rarely be an invasion of the cortex.

Tomography is a study that assists in the three-dimensional view of the tumor and brings important information needed to determine the biological potential of the lesion. Information about bone tumors is the presence of a bone-forming matrix, endosteal erosion, cortical thinning or violation, and the transition.

MRI, on the other hand, plays a fundamental role in the study of malignant bone tumors. With this exam, we may evaluate the pattern of enhancement of resonance, the presence of edema in the bone, and the characteristics of the image. In the case of scintigraphy, it is used to access the presence of multiple sites of involvement that can occur. Examples of this include polyostotic fibrous dysplasia, multiple enchondromatosis, or histiocytosis.

It is important to know that the positivity of this test used in the study of bone neoplasia does not accurately tell us whether it is a bone tumor (benign) or a bone cancer (malignant). When we encounter a cold (negative) injury, we’re led to believe that it is a latent or quiescent injury.

When assessing bone tumor symptoms, a detailed clinical history, a thorough physical examination, and radiographs should be utilized in the evaluation of the orthopedic specialist in bone tumors. This is because a patient who’s experiencing pain, deformity, edema, bone tumors, or a pathological fracture may be diagnosed with a benign injury.

When studying injuries that are very close to the joint, we must take care to ensure there’s a differentiation about whether degenerative joint changes are the cause. Those lesions that show cortical rupture, permeative changes, or periosteal reaction require additional imaging tests. When there is doubt in the diagnosis of bone tumors, a biopsy may be necessary. When it is concluded that the lesion is benign, we must proceed with radiographic observations every 3 months to ensure that there is stability, increasing the time of return progressively.

On the other hand, tumors in the bone may undergo surgical procedures if there’s a risk of fracture or correction of deformities is needed.

Bone cancer – Malignant lesions

Unlike benign bone tumors, malignant lesions will rarely be asymptomatic. They’re characterized by pain that varies in intensity, duration, and characteristics. In such cases, the symptoms do not improve with the use of analgesics.

For lesions that occur in the extremities, for example, cancer in the leg bone, it’s common to notice the presence of a tumor and/or edema. In the case of malignant bone neoplasia, there are laboratory alterations such as hypercalcemia, increased alkaline phosphatase or anemia. It is also important to study whether there is a family history of cancer, since some syndromes predispose the patient’s risk of osteosarcoma, for example retinoblastoma, Li-Fraumeni syndrome and Rothmund-Thompson syndrome.

If bone cancer is suspected, a biopsy is required. It is extremely important that the bone biopsy is planned carefully, as the location of the needle’s insertion must coincide with the path of the surgical incision. Patients over 40 years of age with malignant lesions may be experiencing metastatic carcinoma, multiple myeloma, or lymphoma. To keep track of your condition, we must properly document the breasts and the prostate issue as well. Ordering an electrophoresis may also help with the diagnostic investigation of your condition.

Malignant bone neoplasia treatment

The treatment of malignant tumors is multidisciplinary. This means that it involves several specialties that will act simultaneously to provide the relief you need. This treatment must be performed in a reference center, where adjuvant and neoadjuvant therapies are possible.

Cooperation between the teams is imperative for the patient to submit to an individualized and planned protocol. This involves the date of the surgery, chemotherapy, and radiotherapy—which can be adjuvant or neoadjuvant. Periodic follow-ups are essential for obtaining information about relapses and the presence of metastatic disease.

The Arthroplasty treatment clinic has provided general information on bone tumors to provide a general guide about these pathologies. Visit the dedicated sections for more in-depth information on the pathologies of the skeletal muscle system, such as bone tumors (benign), bone cancer (malignant), metastases, and pseudotumoral lesions.

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